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Esteban J, Salar-Vidal L, Schmitt BH, Waggoner A, Laurent F, Abad L, Bauer TW, Mazariegos I, Balada-Llasat JM, Horn J, Wolk DM, Jefferis A, Hermans M, Verhoofstad I, Butler-Wu SM, Umali-Wilcox M, Murphy C, Cabrera B, Craft D, von Bredow B, Leber A, Everhart K, Dien Bard J, Flores II, Daly J, Barr R, Holmberg K, Graue C, Kensinger B. Multicenter evaluation of the BIOFIRE Joint Infection Panel for the detection of bacteria, yeast, and AMR genes in synovial fluid samples. J Clin Microbiol 2023; 61:e0035723. [PMID: 37877730 PMCID: PMC10662359 DOI: 10.1128/jcm.00357-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/07/2023] [Indexed: 10/26/2023] Open
Abstract
The bioMérieux BIOFIRE Joint Infection (JI) Panel is a multiplex in vitro diagnostic test for the simultaneous and rapid (~1 h) detection of 39 potential pathogens and antimicrobial resistance (AMR) genes directly from synovial fluid (SF) samples. Thirty-one species or groups of microorganisms are included in the kit, as well as several AMR genes. This study, performed to evaluate the BIOFIRE JI Panel for regulatory clearance, provides data from a multicenter evaluation of 1,544 prospectively collected residual SF samples with performance compared to standard-of-care (SOC) culture for organisms or polymerase chain reaction (PCR) and sequencing for AMR genes. The BIOFIRE JI Panel demonstrated a sensitivity of 90.9% or greater for all but six organisms and a positive percent agreement (PPA) of 100% for all AMR genes. The BIOFIRE JI Panel demonstrated a specificity of 98.5% or greater for detection of all organisms and a negative percent agreement (NPA) of 95.7% or greater for all AMR genes. The BIOFIRE JI Panel provides an improvement over SOC culture, with a substantially shorter time to result for both organisms and AMR genes with excellent sensitivity/PPA and specificity/NPA, and is anticipated to provide timely and actionable diagnostic information for joint infections in a variety of clinical scenarios.
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Affiliation(s)
- Jaime Esteban
- IIS-Fundacion Jimenez Diaz, CIBERINFEC-CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Llanos Salar-Vidal
- IIS-Fundacion Jimenez Diaz, CIBERINFEC-CIBER de Enfermedades Infecciosas, Madrid, Spain
| | - Bryan H. Schmitt
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Amy Waggoner
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | | | | | | | | | - Jared Horn
- The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | | | | | | | | | | | | | - Caitlin Murphy
- University of Nebraska Medical Center Omaha, Omaha, Nebraska, USA
| | - Barbara Cabrera
- University of Nebraska Medical Center Omaha, Omaha, Nebraska, USA
| | - David Craft
- The Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | | | - Amy Leber
- Nationwide Children’s Hospital, Columbus, Ohio, USA
| | | | | | | | - Judy Daly
- Primary Children’s Hospital, Salt Lake City, Utah, USA
| | - Rebecca Barr
- Primary Children’s Hospital, Salt Lake City, Utah, USA
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Graue C, Schmitt BH, Waggoner A, Laurent F, Abad L, Bauer T, Mazariegos I, Balada-Llasat JM, Horn J, Wolk D, Jefferis A, Hermans M, Verhoofstad I, Butler-Wu S, Butler-Wu S, Umali-Wilcox M, Murphy CN, Cabrera BJ, Esteban J, Macias-Valcayo A, Craft D, von Bredow B, Leber A, Everhart K, Bard JD, Mestas J, Daly J, Barr R, Kensinger B, Pons B, Jay C. 322. Evaluation of the BioFire® Bone and Joint Infection (BJI) Panel for the Detection of Microorganisms and Antimicrobial Resistance Genes in Synovial Fluid Specimens. Open Forum Infect Dis 2020. [PMCID: PMC7777965 DOI: 10.1093/ofid/ofaa439.518] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Bone and Joint Infections (BJIs) present with non-specific symptoms that may include pain, swelling, and fever and are associated with high morbidity and significant risk of mortality. BJIs can be caused by a variety of bacteria and fungi, including anaerobes and microorganisms that can be challenging to culture or identify by traditional microbiological methods. Clinicians primarily rely on culture to identify the pathogen(s) responsible for infection. The BioFire® Bone and Joint Infection (BJI) Panel (BioFire Diagnostics, Salt Lake City, UT) is designed to detect 15 gram-positive bacteria (including seven anaerobes), 14 gram-negative bacteria (including one anaerobe), two yeast, and eight antimicrobial resistance (AMR) genes from synovial fluid specimens in about an hour. The objective of this study was to evaluate the performance of an Investigational Use Only (IUO) version of the BioFire BJI Panel compared to various reference methods. Methods Remnant synovial fluid specimens, which were collected for routine clinical care at 13 study sites in the US and Europe, underwent testing using an IUO version of the BioFire BJI Panel. Performance of this test was determined by comparison to Standard of Care (SoC) consisting of bacterial culture performed at each study site according to their routine procedures. Results A total of 1544 synovial fluid specimens were collected and tested with the BioFire BJI Panel. The majority of specimens were from knee joints (77.9%) and arthrocentesis (79.4%) was the most common collection method. Compared to SoC culture, overall sensitivity was 90.2% and specificity was 99.8%. The BioFire BJI Panel yielded a total of 268 Detected results, whereas SoC yielded a total of 215 positive results for on-panel analytes. Conclusion The BioFire BJI Panel is a sensitive, specific, and robust test for rapid detection of a wide range of analytes in synovial fluid specimens. The number of microorganisms and resistance genes included in the BioFire BJI Panel, together with a reduced time-to-result and increased diagnostic yield compared to culture, is expected to aid in the timely diagnosis and appropriate management of BJIs. Disclosures Benjamin von Bredow, PhD, BioFire (Grant/Research Support) Jennifer Dien Bard, PhD, BioFire Diagnostic (Consultant, Scientific Research Study Investigator) Bart Kensinger, PhD, BioFire Diagnostics (Employee) Benedicte Pons, PhD, bioMerieux SA (Employee) Corinne Jay, PhD, bioMerieux SA (Employee)
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Affiliation(s)
| | - Bryan H Schmitt
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Amy Waggoner
- Indiana University School of Medicine, Indianapolis, Indiana
| | - Frederic Laurent
- French National Reference Center for Staphylococci, Lyon, Rhone-Alpes, France
| | - Lelia Abad
- Hospices Civils de Lyon (Centre Hospitalier Universitaire de Lyon), Lyon, Rhone-Alpes, France
| | - Thomas Bauer
- Hospital for Special Surgery, New York, New York
| | | | | | - Jarid Horn
- The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Donna Wolk
- Geisinger Medical Center, Danville, Pennsylvania
| | | | - Mirjam Hermans
- jeroen bosch ziekenhuis, ‘s-Hertogenbosch, Noord-Brabant, Netherlands
| | - Irma Verhoofstad
- jeroen bosch ziekenhuis, ‘s-Hertogenbosch, Noord-Brabant, Netherlands
| | | | | | | | | | | | - Jaime Esteban
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Madrid, Spain
| | | | - David Craft
- Penn State Hershey Medical Center, Hershey, Pennsylvania
| | | | - Amy Leber
- Nationwide Children’s Hospital, Columbus, OH
| | | | | | - Javier Mestas
- Children’s Hospital Los Angeles, Los Angeles, California
| | - Judy Daly
- Primary Children’s Hospital, Salt Lake City, UT
| | | | | | | | - Corinne Jay
- bioMerieux SA, Grenoble, Rhone-Alpes, France
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Roos MT, van Lier RA, Hamann D, Knol GJ, Verhoofstad I, van Baarle D, Miedema F, Schellekens PT. Changes in the composition of circulating CD8+ T cell subsets during acute epstein-barr and human immunodeficiency virus infections in humans. J Infect Dis 2000; 182:451-8. [PMID: 10915075 DOI: 10.1086/315737] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/1999] [Revised: 05/03/2000] [Indexed: 11/04/2022] Open
Abstract
In response to viral infection, unprimed naive CD8(+), major histocompatibility complex class I-restricted, virus-specific T cells clonally expand and differentiate into memory- and effector-type cells. Changes in CD8(+) subset distribution were studied in 17 subjects with acute human immunodeficiency virus type 1 infection and in 14 subjects with acute Epstein-Barr virus (EBV) infection, with combined CD45RO, CD27, and CD28 monoclonal antibodies. A vast expansion of memory-type CD45RO(+)CD27(+)CD8(+) T cells, with high expression of the cell-cycle marker Ki-67, was observed in both infections. Strikingly, CD45RO(+)CD27(+)CD28(-) cells increased >10-fold in acute viral infection and had high Ki-67 expression. In acute EBV infection, a substantial portion of the expanded T cells were EBV-peptide specific. These cells resided mainly in the CD45RO(+)CD27(+) subpopulation, with most in the CD27(+)CD28(-) subpopulation. Content of perforin expression, as a measure of cytotoxic capacity, was relatively low in the CD27(+)CD28(+) T cells and highest in the CD27(-)CD28(-) subpopulation.
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Affiliation(s)
- M T Roos
- Department of Clinical Viro-Immunology, CLB and Laboratory for Experimental and Clinical Immunology of the University of Amsterdam at the CLB, Amsterdam, The Netherlands.
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