Molecular Culture for Joint Infection Diagnostics
Background & Aim
Culture is currently the routine diagnostic tool for joint infections. However, culture suffers from long turn-around times. This leads to overtreatment with broad-spectrum antibiotics, unnecessary surgery, and long hospital admission. Molecular Culture may significantly improve the speed of diagnosis and impact clinical workflow.
- >2 million prosthetic joints per year in the US and EU
- High infection rate of 2-3%
- High costs €50.000 per treated PJI
- Mortality rate of PJI higher than breast cancer
Aim: Determine whether Molecular Culture can replace traditional culture to diagnose joint infections.
Methods.
- 591 joint aspirates were consecutively collected
- 293 native joints
- 298 prosthetic joints
- All samples were processed by Molecular Culture and traditional culture
- Results were compared
Results.
- At sample level, percent positive agreement (PPA) between IS-pro and culture was 90.6% (95% CI 85.7- to 94%) and negative percent agreement (NPA) was 87.7%(95% CI 84.1 to 90.6%).
- At species level, PPA was 80% (95% CI 74.3 to 84.7%).
- IS-pro yielded 83 extra bacterial detections over the culture for which we found supporting evidence for true positivity in 40% of the extra detections.
- Missed detections by IS-pro were mostly related to common skin species in low abundance.
Conclusion: Molecular Culture shows an excellent performance for fast diagnostics of bacterial BJI
Clinical workflow traditional culturing.
❌ Treatment, is based on suspicion, not on diagnosis
❌ Overuse of antibiotics
❌ Unnecessary operations and complications
❌ Long hospital stay
✅ Rapid accurate therapy based on diagnosis
✅ Costly operation if needed only
✅ Faster patient recovery with less complications
✅ Lower healthcare costs
Clinical workflow with
Molecular Culture.
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