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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.

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procedures, timelines & outcomes


  • 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
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  • 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

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Venn diagrams

Clinical workflow traditional culturing.

Workflow Traditional Culturing

❌    Treatment, is based on suspicion, not on diagnosis
❌    Overuse of antibiotics
❌    Unnecessary operations and complications
❌    Long hospital stay

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✅ Rapid accurate therapy based on diagnosis
✅ Costly operation if needed only
✅ Faster patient recovery with less complications
✅ Lower healthcare costs

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Clinical workflow with
Molecular Culture.

Workflow Molecular Culture

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