Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May;12(5):1437-1443.
doi: 10.1007/s40121-023-00809-x. Epub 2023 May 2.

Real-Life Experience and Diagnostic Utility of the BioFire Joint Infection PCR Panel in Bone and Joint Infections: Analysis of a Prospective Validation Study

Tomer Hoffman  1 , Or Kriger  2 , Shoshana Cohen  2 , Shiraz Gefen-Halevi  2 , Dafna Yahav  3 , Sharon Amit  2
Affiliations

Real-Life Experience and Diagnostic Utility of the BioFire Joint Infection PCR Panel in Bone and Joint Infections: Analysis of a Prospective Validation Study

Tomer Hoffman et al. Infect Dis Ther. 2023 May.

Abstract

Introduction: Microbiological diagnosis is central for adequate treatment of bone and joint infections. Culture-based methods have a limited diagnostic sensitivity and a long turnaround time (TAT). The objective of this study was to compare the diagnostic performance of BioFire Joint Infection Panel Investigational Use Only version (hereafter BioFire)-a sample-to-result multiplex PCR panel-with culture-based methods and 16S ribosomal RNA (rRNA) PCR and sequencing, when available.

Methods: This study presents a retrospective analysis of a prospective validation study of the BioFire panel. Specimens were obtained from consecutive patients evaluated for suspected bone and joint infections and processed using culture, BioFire, and 16S rRNA PCR and sequencing. Final clinical diagnosis was used as the reference for definition of infection.

Results: Samples, including synovial fluid, bone and periarticular tissue, were obtained from 57 patients, 39 of whom were finally diagnosed with a bone or joint infection. Cultures were positive in 27/39 infected patients and in 3/18 uninfected patients (sensitivity 69%, specificity 83%). BioFire was positive in 22/39 infected patients and in none of the uninfected patients (sensitivity 56%, specificity 100%). Sensitivity for PCR panel organisms was 92% (22/24) and sensitivity for organisms identified by any microbiological modality was 69% (22/32). Gram stain results were positive in 13/39 infected patients and in none of the uninfected patients (sensitivity 33%, specificity 100%). 16S rRNA was positive in 20/28 infected patients and in 0/12 uninfected patients (sensitivity 71%, specificity 100%). Net machine time for BioFire-1 h-was shorter than the mean TAT for Gram stain results, which was 4 h.

Conclusion: BioFire offered equivalent diagnostic performance with superior TAT for bone and joint infections, compared with conventional methods.

Keywords: 16S rRNA; BioFire; Bone and joint infections; Molecular diagnosis; Multiplex PCR.

PubMed Disclaimer

Conflict of interest statement

Tomer Hoffman, Or Kriger, Shoshana Cohen, Shiraz Gefen Halevi, Dafna Yahav, and Sharon Amit have nothing to disclose.

References

    1. Graue C, Schmitt BH, Waggoner A, Laurent F, Abad L, Bauer T, et al. Evaluation of the BioFire® bone and joint infection (BJI) panel for the detection of microorganisms and antimicrobial resistance genes in synovial fluid specimens. Open Forum Infect Dis [Internet]. 2020;7:S233–4. Available at: https://academic.oup.com/ofid/article/7/Supplement_1/S233/6058676
    1. Jacquier H, Fihman V, Amarsy R, Vicaut E, Bousson V, Cambau E, et al. Benefits of polymerase chain reaction combined with culture for the diagnosis of bone and joint infections: a prospective test performance study. Open Forum Infect Dis. Oxford University Press. 2019. - PMC - PubMed
    1. Berneking L, Haas M, Frielinghaus L, Berinson B, Lütgehetmann M, Christner M, et al. Evaluation of a syndromic panel polymerase chain reaction (spPCR) assay for the diagnosis of device‐associated bone and joint infections (BJI). International Journal of Infectious Diseases. Elsevier B.V. 2022;116:283–8. - PubMed
    1. Malandain D, Bémer P, Leroy AG, Léger J, Plouzeau C, Valentin AS, et al. Assessment of the automated multiplex-PCR Unyvero i60 ITI® cartridge system to diagnose prosthetic joint infection: a multicentre study. Clinical Microbiology and Infection. Elsevier B.V.; 2018;24:83.e1–83.e6. - PubMed
    1. Puhto AP, Puhto T, Niinimäki T, Ohtonen P, Leppilahti J, Syrjälä H. Predictors of treatment outcome in prosthetic joint infections treated with prosthesis retention. Int Orthop Springer Verlag. 2015;39:1785–1791. doi: 10.1007/s00264-015-2819-2. - DOI - PubMed

LinkOut - more resources