{"title":"Evaluation of the BioFire joint infection panel in Taiwan: Impact of regional non-target pathogens and joint type on its performance.","authors":"Shih-Hao Lo, Chieh Chin, Hsuan-Ti Huang, Cheng-Jung Ho, Yu-Te Tsai, Po-Liang Lu, Chao-Ju Chen, Shin-Huei Kuo, Shang-Yi Lin","doi":"10.1016/j.jmii.2026.10.004","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>The BIOFIRE® Joint Infection (BJI) panel, a rapid multiplex polymerase chain reaction assay, is used to diagnose joint infections. Here we used it to evaluate the clinical performance and impact of antimicrobial resistance (AMR) detection in Taiwan's unique microbial landscape.</p><p><strong>Methods: </strong>Adult patients with suspected septic arthritis or prosthetic joint infection were prospectively enrolled from four hospitals in southern Taiwan. Synovial fluid specimens were tested using a BJI panel and routine bacterial culturing. Performance was assessed by calculating the positive percent agreement and negative percent agreement (PPA and NPA, respectively).</p><p><strong>Results: </strong>Eighty-six specimens (native joints, 56; prosthetic joints, 30) were analyzed. The overall PPA and NPA were 92.3% and 76.7%, respectively. Native joints showed higher concordance (PPA, 93.8%; NPA, 85.0%) than prosthetic joints (PPA, 90.0%; NPA, 60.0%). The BJI panel detected pathogens in 14 culture-negative cases, predominantly among patients who previously received antibiotics. Notably, the panel identified six methicillin-resistant Staphylococcus aureus cases (three culture-negative) and one bla<sub>CTX-M</sub>-positive E. coli detection. However, three culture-positive cases involving \"off-panel\" regional pathogens (Burkholderia pseudomallei, n = 2; Mycobacterium tuberculosis complex, n = 1) were BJI-negative. Diagnostic concordance is better in native joints and correlated significantly with higher synovial leukocyte counts.</p><p><strong>Conclusions: </strong>Our evaluation revealed the BJI panel's ability to rapidly identify pathogens and profile AMR, with additional diagnostic yield particularly in culture-negative prosthetic joint infections and in patients with prior antibiotic exposure. However, its limited detection targets leave a diagnostic gap for regionally endemic pathogens such as Burkholderia pseudomallei and Mycobacterium tuberculosis complex, indicating the continued need for conventional culturing.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Microbiology Immunology and Infection","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jmii.2026.10.004","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: The BIOFIRE® Joint Infection (BJI) panel, a rapid multiplex polymerase chain reaction assay, is used to diagnose joint infections. Here we used it to evaluate the clinical performance and impact of antimicrobial resistance (AMR) detection in Taiwan's unique microbial landscape.
Methods: Adult patients with suspected septic arthritis or prosthetic joint infection were prospectively enrolled from four hospitals in southern Taiwan. Synovial fluid specimens were tested using a BJI panel and routine bacterial culturing. Performance was assessed by calculating the positive percent agreement and negative percent agreement (PPA and NPA, respectively).
Results: Eighty-six specimens (native joints, 56; prosthetic joints, 30) were analyzed. The overall PPA and NPA were 92.3% and 76.7%, respectively. Native joints showed higher concordance (PPA, 93.8%; NPA, 85.0%) than prosthetic joints (PPA, 90.0%; NPA, 60.0%). The BJI panel detected pathogens in 14 culture-negative cases, predominantly among patients who previously received antibiotics. Notably, the panel identified six methicillin-resistant Staphylococcus aureus cases (three culture-negative) and one blaCTX-M-positive E. coli detection. However, three culture-positive cases involving "off-panel" regional pathogens (Burkholderia pseudomallei, n = 2; Mycobacterium tuberculosis complex, n = 1) were BJI-negative. Diagnostic concordance is better in native joints and correlated significantly with higher synovial leukocyte counts.
Conclusions: Our evaluation revealed the BJI panel's ability to rapidly identify pathogens and profile AMR, with additional diagnostic yield particularly in culture-negative prosthetic joint infections and in patients with prior antibiotic exposure. However, its limited detection targets leave a diagnostic gap for regionally endemic pathogens such as Burkholderia pseudomallei and Mycobacterium tuberculosis complex, indicating the continued need for conventional culturing.
期刊介绍：
Journal of Microbiology Immunology and Infection is an open access journal, committed to disseminating information on the latest trends and advances in microbiology, immunology, infectious diseases and parasitology. Article types considered include perspectives, review articles, original articles, brief reports and correspondence.
With the aim of promoting effective and accurate scientific information, an expert panel of referees constitutes the backbone of the peer-review process in evaluating the quality and content of manuscripts submitted for publication.
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