Clinical Information

Joint infections (JI) occur when pathogens access bones and joints via hematogenous spread, contiguous spread of pathogens from an adjacent infection, or direct implantation (eg, open fracture, surgery, implanted medical devices). JI broadly encompasses multiple types of infections including, but not limited to, septic arthritis (SA), and prosthetic joint infection (PJI). These infections are commonly diagnosed by a combination of laboratory results, microbiological data, histological evaluation of tissue, intraoperative inspection, and in some cases radiographic results.(1) JI are most often caused by bacterial pathogens, though yeasts are also a significant cause. Serious morbidity can arise from JI, resulting in significant pain, permanent disability, or death.(2) Additionally, JI are often complicated and result in increased hospital stay length as well as higher rates of long-term rehabilitation and rehospitalization.(3,4) Globally, the prevalence of JI is estimated to be four to ten per 100,000 people in developed countries, with the economic impact of such infections totaling hundreds of millions of dollars per year.(4,5)

Timely diagnosis of JI and administration of effective treatment can significantly reduce the rates of serious complications, duration of hospital stays, and costs. The BIOFIRE JI Panel tests a single synovial fluid sample to simultaneously provide results for multiple aerobic and anaerobic bacteria and yeast that cause JI as well as genetic markers associated with antimicrobial resistance. Although JI is a broad category that includes multiple types of infections, the BIOFIRE JI Panel was primarily designed to detect organisms associated with SA and PJI. Rapid identification of the organism(s) in synovial fluid, along with information about antimicrobial resistance gene status for select microorganisms, may aid the physician in making timely and appropriate treatment and management decisions.

The BIOFIRE JI Panel is indicated as an aid in the diagnosis of specific agents of JI and results should be used in conjunction with other clinical and laboratory findings. Negative results may be due to infection with pathogens that are not detected by this test, pathogens present below the limit of detection of the assay, or infection that may not be detected in a synovial fluid specimen. Positive results do not rule out co-infection with other organisms. The BIOFIRE JI Panel is not intended to monitor treatment for JI.

Culture of synovial fluid is necessary to recover organisms for susceptibility testing and epidemiological typing, to identify organisms in the synovial fluid that are not detected by the BIOFIRE JI Panel, and to further identify species in the genus, complex, or group results.