Comparison of the BioFire Joint Infection Panel to 16S Ribosomal RNA Gene-Based Targeted Metagenomic Sequencing for Testing Synovial Fluid from Patients with Knee Arthroplasty Failure

• Published in: Journal of clinical microbiology 2022-12, Vol.60 (12), p.e0112622
• Main Authors: Azad, Marisa A, Wolf, Matthew J, Strasburg, Angela P, Daniels, Matthew L, Starkey, Jordan C, Donadio, Alexander D, Abdel, Matthew P, Greenwood-Quaintance, Kerryl E, Patel, Robin
• Format: Article
• Language: English
• Subjects: Arthritis, Infectious - diagnosis; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Knee - adverse effects; Bacteriology; Biomarkers; Clinical Microbiology; Editor's Pick; Genes, rRNA; Humans; Prosthesis-Related Infections - diagnosis; Prosthesis-Related Infections - etiology; RNA, Ribosomal, 16S - genetics; Sensitivity and Specificity; Synovial Fluid
• ISSN: 0095-1137; 1098-660X
• DOI: 10.1128/jcm.01126-22

The diagnosis of periprosthetic joint infection (PJI) is challenging, often requiring multiple clinical specimens and diagnostic techniques, some with prolonged result turnaround times. Here, the diagnostic performance of the Investigational Use Only (IUO) BioFire Joint Infection (JI) Panel was compared to 16S rRNA gene-based targeted metagenomic sequencing (tMGS) applied to synovial fluid for PJI diagnosis. Sixty synovial fluid samples from knee arthroplasty failure archived at -80°C were tested. Infectious Diseases Society of America (IDSA) diagnostic criteria were used to classify PJI. For culture-positive PJI with pathogens targeted by the JI panel, JI panel sensitivity was 91% (21/23; 95% confidence interval [CI], 73 to 98%), and tMGS sensitivity was 96% (23/24; 95% CI, 80 to 99%) (  = 0.56). Overall sensitivities of the JI panel and tMGS for PJI diagnosis were 56% (24/43; 95% CI, 41 to 70%) and 93% (41/44; 95% CI, 82 to 98%), respectively (