Evaluation of a fully automated multiplex PCR panel for the microbiological diagnosis of joint infections.

AIMS: Rapid identification of the causative microorganisms of osteoarticular infections is essential for successful treatment. BIOFIRE® FilmArray® Joint Infection Panel (JI panel), a fully automated multiplex PCR panel, can rapidly detect pathogens and antimicrobial resistance genes in the synovial joints in patients with acute osteoarticular infections. Accordingly, this study aimed to evaluate the diagnostic method of the JI panel in patients with osteoarticular infections.

METHODS

Synovial fluid samples were collected from patients with suspected osteoarticular infections. Fifty-five samples from 49 patients were analysed. The JI panel results were compared with those obtained using conventional culture methods.

RESULTS

The sensitivities of the JI panel and culture for detecting microorganisms were 55 and 61 %, respectively, while the specificities were both 100 %. For patients with osteoarticular infections (n = 23) and positive culture or JI panel, the agreement rate between the JI panel and culture was 65 %. In five samples (22 %), the culture was positive, but the JI panel was negative. In three of the five JI panel-negative specimens (13 %), the bacteria identified in the culture were not included in the panel design. Three culture-negative specimens were JI panel-positive. Significantly higher sensitivity (70 % vs. 55 %; P = 0.008) was observed with the combined JI panel and culture than with the JI panel alone.

CONCLUSION

The JI panel is a useful technique to identify causative bacteria rapidly and automatically, but the combination of the JI panel and culture methods is recommended because some pathogens are not included in the JI panel.

LEVEL OF EVIDENCE: Diagnostic level III.