An Evaluation of a Syndromic Molecular Panel in Optimising the Microbiological Diagnosis and Antimicrobial Therapy of Suspected Osteoarticular Infections in Paediatric Patients
<b>Background/Objectives:</b> Paediatric osteoarticular infections (POAIs) present unique diagnostic and therapeutic challenges. Microbiological culture (MC) is typically time-consuming and lacks sensitivity, especially when patients have received antibiotics. The BIOFIRE<sup>®<...
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2025-02-01
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| author | Marilena Agosta Venere Cortazzo Manuela Onori Barbara Lucignano Gianluca Vrenna Martina Rossitto Maria del Carmen Pereyra Boza Valeria Fox Marco Roversi Antonio Musolino Andrzej Krzysztofiak Laura Lancella Marco Giordano Francesco Falciglia Ottavia Porzio Alberto Villani Carlo Federico Perno Paola Bernaschi |
| author_facet | Marilena Agosta Venere Cortazzo Manuela Onori Barbara Lucignano Gianluca Vrenna Martina Rossitto Maria del Carmen Pereyra Boza Valeria Fox Marco Roversi Antonio Musolino Andrzej Krzysztofiak Laura Lancella Marco Giordano Francesco Falciglia Ottavia Porzio Alberto Villani Carlo Federico Perno Paola Bernaschi |
| author_sort | Marilena Agosta |
| collection | DOAJ |
| description | <b>Background/Objectives:</b> Paediatric osteoarticular infections (POAIs) present unique diagnostic and therapeutic challenges. Microbiological culture (MC) is typically time-consuming and lacks sensitivity, especially when patients have received antibiotics. The BIOFIRE<sup>®</sup> Joint Infection Panel (BJIP) is a syndromic molecular assay for the direct identification of most pathogens causing POAIs. <b>Methods:</b> We evaluated BJIP in 17 synovial fluids, and then, we retrospectively assessed its utility in 93 off-label specimens (i.e., 25 purulent fluids/biopsies and 68 whole blood samples). All specimens were collected from October 2022 to March 2024 from paediatric patients admitted at the Bambino Gesù Children’s Hospital in Rome. <b>Results:</b> A bacterial pathogen was isolated in only one of 17 synovial fluid cultures, while BJIP identified eight additional microorganisms in MC-negative cases. The most frequently detected pathogen was <i>S. aureus</i> (44.5%, 4/9). BJIP performance in synovial fluids showed an overall positive percentage agreement (PPA) and negative percentage agreement (NPA) of 100% and 88.1%, respectively, compared to MC. All positive results (n/N = 9/17) were considered medically significant, with an increase in NPA to 100%. In purulent fluids/biopsies, BJIP and MC were concordant in 72% of cases (n/N = 18/25), with a per-sample PPA and NPA of 90% and 60%, respectively. For whole blood samples, almost all samples were negative by both methods (i.e., reference blood culture and BJIP), and the molecular test did not enable any further microbiological diagnosis. <b>Conclusions:</b> The BIOFIRE<sup>®</sup> Joint Infection Panel rapidly and accurately enabled or excluded a diagnosis of a POAI (~1 vs. 24–96 h for MC), optimising antimicrobial therapy. |
| format | Article |
| id | doaj-art-cdd9cfb1ccaa4298b049e54a7adcaaf8 |
| institution | DOAJ |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-cdd9cfb1ccaa4298b049e54a7adcaaf82025-08-20T02:52:45ZengMDPI AGDiagnostics2075-44182025-02-0115556610.3390/diagnostics15050566An Evaluation of a Syndromic Molecular Panel in Optimising the Microbiological Diagnosis and Antimicrobial Therapy of Suspected Osteoarticular Infections in Paediatric PatientsMarilena Agosta0Venere Cortazzo1Manuela Onori2Barbara Lucignano3Gianluca Vrenna4Martina Rossitto5Maria del Carmen Pereyra Boza6Valeria Fox7Marco Roversi8Antonio Musolino9Andrzej Krzysztofiak10Laura Lancella11Marco Giordano12Francesco Falciglia13Ottavia Porzio14Alberto Villani15Carlo Federico Perno16Paola Bernaschi17Microbiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyMicrobiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyMicrobiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyMicrobiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyMultimodal Laboratory Medicine, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyMultimodal Laboratory Medicine, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyMicrobiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyMultimodal Laboratory Medicine, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyPhD Program in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, 00133 Rome, ItalyResidency School of Pediatrics, University of Rome Tor Vergata, 00133 Rome, ItalyInfectious Diseases and Immunoinfectivology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyInfectious Diseases and Immunoinfectivology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyOrthopedics and Traumatology Unit, Bambino Gesù Children’s Hospital, IRCSS, 00165 Rome, ItalyOrthopedics and Traumatology Unit, Bambino Gesù Children’s Hospital, IRCSS, 00165 Rome, ItalyClinical Laboratory Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyGeneral Pediatric and Infectious Disease Unit, Pediatric Emergency Medicine, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyMicrobiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, ItalyMicrobiology and Diagnostic Immunology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy<b>Background/Objectives:</b> Paediatric osteoarticular infections (POAIs) present unique diagnostic and therapeutic challenges. Microbiological culture (MC) is typically time-consuming and lacks sensitivity, especially when patients have received antibiotics. The BIOFIRE<sup>®</sup> Joint Infection Panel (BJIP) is a syndromic molecular assay for the direct identification of most pathogens causing POAIs. <b>Methods:</b> We evaluated BJIP in 17 synovial fluids, and then, we retrospectively assessed its utility in 93 off-label specimens (i.e., 25 purulent fluids/biopsies and 68 whole blood samples). All specimens were collected from October 2022 to March 2024 from paediatric patients admitted at the Bambino Gesù Children’s Hospital in Rome. <b>Results:</b> A bacterial pathogen was isolated in only one of 17 synovial fluid cultures, while BJIP identified eight additional microorganisms in MC-negative cases. The most frequently detected pathogen was <i>S. aureus</i> (44.5%, 4/9). BJIP performance in synovial fluids showed an overall positive percentage agreement (PPA) and negative percentage agreement (NPA) of 100% and 88.1%, respectively, compared to MC. All positive results (n/N = 9/17) were considered medically significant, with an increase in NPA to 100%. In purulent fluids/biopsies, BJIP and MC were concordant in 72% of cases (n/N = 18/25), with a per-sample PPA and NPA of 90% and 60%, respectively. For whole blood samples, almost all samples were negative by both methods (i.e., reference blood culture and BJIP), and the molecular test did not enable any further microbiological diagnosis. <b>Conclusions:</b> The BIOFIRE<sup>®</sup> Joint Infection Panel rapidly and accurately enabled or excluded a diagnosis of a POAI (~1 vs. 24–96 h for MC), optimising antimicrobial therapy.https://www.mdpi.com/2075-4418/15/5/566paediatric osteoarticular infectionsseptic arthritisrapid diagnosticmolecular syndromic approach |
| spellingShingle | Marilena Agosta Venere Cortazzo Manuela Onori Barbara Lucignano Gianluca Vrenna Martina Rossitto Maria del Carmen Pereyra Boza Valeria Fox Marco Roversi Antonio Musolino Andrzej Krzysztofiak Laura Lancella Marco Giordano Francesco Falciglia Ottavia Porzio Alberto Villani Carlo Federico Perno Paola Bernaschi An Evaluation of a Syndromic Molecular Panel in Optimising the Microbiological Diagnosis and Antimicrobial Therapy of Suspected Osteoarticular Infections in Paediatric Patients Diagnostics paediatric osteoarticular infections septic arthritis rapid diagnostic molecular syndromic approach |
| title | An Evaluation of a Syndromic Molecular Panel in Optimising the Microbiological Diagnosis and Antimicrobial Therapy of Suspected Osteoarticular Infections in Paediatric Patients |
| title_full | An Evaluation of a Syndromic Molecular Panel in Optimising the Microbiological Diagnosis and Antimicrobial Therapy of Suspected Osteoarticular Infections in Paediatric Patients |
| title_fullStr | An Evaluation of a Syndromic Molecular Panel in Optimising the Microbiological Diagnosis and Antimicrobial Therapy of Suspected Osteoarticular Infections in Paediatric Patients |
| title_full_unstemmed | An Evaluation of a Syndromic Molecular Panel in Optimising the Microbiological Diagnosis and Antimicrobial Therapy of Suspected Osteoarticular Infections in Paediatric Patients |
| title_short | An Evaluation of a Syndromic Molecular Panel in Optimising the Microbiological Diagnosis and Antimicrobial Therapy of Suspected Osteoarticular Infections in Paediatric Patients |
| title_sort | evaluation of a syndromic molecular panel in optimising the microbiological diagnosis and antimicrobial therapy of suspected osteoarticular infections in paediatric patients |
| topic | paediatric osteoarticular infections septic arthritis rapid diagnostic molecular syndromic approach |
| url | https://www.mdpi.com/2075-4418/15/5/566 |
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