BioFire in osteoarticular Infections: Rapid syndromic testing for early and accurate diagnosis – A narrative review

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-05-08 DOI:10.1016/j.jcot.2025.103038

Vibhu Krishnan Viswanathan , Vijay Kumar Jain , Karthikeyan P. Iyengar , Raju Vaishya

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引用次数: 0

Abstract

Introduction

In the increasing peril due to multidrug-resistant (MDR) pathogens, importance of novel molecular technologies for rapid pathogen identification has been acknowledged. In this context, the role of multiplex molecular technique, BioFire® Arthritis panel (BFAP) in the evaluation of osteoarticular infections (OI) has been recognized. The current review was performed to comprehensively evaluate the status of BFAP in OI.

Methods

A literature search was performed in June 2024 using five databases. Clinical studies (prospective and retrospective series) evaluating the role of BFAP in OI were considered. Experimental studies, editorials, and reviews were excluded. A narrative approach was used for the synthesis of results.

Results

Ten manuscripts were finally selected for the review. This test uses cartridge methodology, and the panel includes 31 microorganisms and eight resistance markers. The panel consists of nucleic acid extraction, reverse transcription, amplification of nucleic acid, and analysis of results in an automated manner (approximated duration of 1 h/run). It has been acknowledged for providing rapid results with relatively good diagnostic precision (90.9 % sensitivity, 98.5 % specificity). However, when off-panel pathogens (like Staphylococcus epidermidis/Cutibacterium acnes) are considered, sensitivity drops to 56 %. It significantly impacts its accuracy and false negative results.

Conclusion

The benefits of the BioFire® panel include rapid turn-around time, excellent sensitivity and specificity for on-panel pathogens, and ability to identify antimicrobial resistance. The benefits of BFAP are demonstrated in native septic arthritis and OI in pediatric population. In view of exclusion of specific organisms, its sensitivity and accuracy in diagnosing PJI (early acute PJI) and chronic infections are low.

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BioFire骨关节感染：快速综合征测试早期和准确诊断-叙述性回顾

在多重耐药（MDR）病原体日益增加的危险中，新型分子技术对快速鉴定病原体的重要性已经得到承认。在此背景下，多重分子技术BioFire®Arthritis panel （BFAP）在评估骨关节感染（OI）中的作用已得到认可。目前的回顾是为了全面评估成骨不全症中BFAP的状况。方法于2024年6月对5个数据库进行文献检索。评估BFAP在OI中的作用的临床研究（前瞻性和回顾性系列）被考虑。实验研究、社论和综述被排除在外。综合结果采用叙述方法。结果10篇稿件最终入选审稿。该测试采用药筒方法，检测组包括31种微生物和8种耐药性标记物。面板包括核酸提取、反转录、核酸扩增和自动分析结果（大约持续1小时/次）。它已被公认为提供快速的结果和相对较好的诊断精度（90.9%的灵敏度，98.5%的特异性）。然而，当考虑到面板外病原体（如表皮葡萄球菌/痤疮角质杆菌）时，敏感性下降到56%。它显著影响其准确性和假阴性结果。结论BioFire®试剂盒的优点包括周转时间短，对试剂盒上病原体具有出色的敏感性和特异性，以及能够识别抗微生物药物耐药性。BFAP在小儿原发性感染性关节炎和成骨不全症中的疗效得到证实。由于排除了特定生物，其诊断PJI（早期急性PJI）和慢性感染的敏感性和准确性较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.