Clinical evaluation of a multiplex PCR-based test for joint infection: a prospective diagnostic accuracy study of forty-nine patients

Eur J Orthop Surg Traumatol. 2024 Dec;34(8):4105-4111. doi: 10.1007/s00590-024-04114-2. Epub 2024 Oct 2.

Abstract

Purpose: The purpose of this study was to evaluate the diagnostic accuracy (sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV)) of the PCR-based BioFire® Joint Infection Panel (BJI Panel) against microbiological culture growth for patients suspected of having a native or prosthetic joint infection.

Methods: Synovial fluid and tissue biopsies were prospectively collected from patients from June 2022 to June 2023. The results of the BJI Panel were compared with those of culture growth.

Results: 51 samples were included. Including all pathogens, the sensitivity was 69%, the specificity 89%, the PPV 73% and the NPV 86%. Including only pathogens in the BJI Panel, the sensitivity was 100%, the specificity 90%, the PPV 73% and the NPV 100%.

Conclusion: The BJI Panel has a high accuracy for detecting the pathogens in its panel, but the absence of important common pathogens from the panel reduces its sensitivity and NPV. With a short turnaround time and precise pathogen detection, the BJI Panel has the potential to add value as a complementary diagnostic method.

Keywords: Culture growth; Diagnostic accuracy; Joint infection; PCR; Pathogen detection.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthritis, Infectious / diagnosis
  • Arthritis, Infectious / microbiology
  • Biopsy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multiplex Polymerase Chain Reaction* / methods
  • Predictive Value of Tests
  • Prospective Studies
  • Prosthesis-Related Infections* / diagnosis
  • Prosthesis-Related Infections* / microbiology
  • Sensitivity and Specificity*
  • Synovial Fluid* / microbiology