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多重PCR检测板(BioFire联合感染检测)在经验性抗菌治疗调整中的临床应用:小儿骨关节炎感染的经验

Clinical Utility of a Multiplex PCR Panel (BioFire Joint Infection) in the Adjustment of Empiric Antimicrobial Therapy: Experience in Pediatric Osteoarticular Infections.

作者信息

Udaondo Clara, Alcobendas Rueda Rosa María, Diaz-Delgado Blanca, Remesal Agustin, Quiles-Melero Inmaculada, Calvo Cristina

机构信息

Pediatric Rheumatology, Hospital Universitario La Paz, 28046 Madrid, Spain.

CIBERINFEC, Consorcio de Investigación Biomédica en Red, Hospital Carlos III, 28029 Madrid, Spain.

出版信息

Children (Basel). 2024 Oct 14;11(10):1236. doi: 10.3390/children11101236.

Abstract

BACKGROUND/OBJECTIVES: This study aims to evaluate the impact of the PCR multiplex panel (BioFire JI) on the diagnosis and management of pediatric osteoarticular infections.

METHODS

This retrospective study analyzed data from pediatric patients diagnosed with osteoarticular infections between January 2023 and April 2024. The effectiveness of the PCR multiplex panel in identifying pathogens was compared with traditional culture methods.

RESULTS

In total, 50 patients were identified (66.6% male, 74% under 3 years of age). They were diagnosed as follows: septic arthritis in 46%, osteomyelitis in 26%, and septic osteoarthritis in 22%. An identifiable agent was isolated by conventional culture in 22 cases (44%). was the predominant pathogen identified, accounting for 50% of cases (11/22), followed by (9/22). The BioFire JI Panel PCR demonstrated a sensitivity of 93%, with a specificity of 63% when evaluated against synovial fluid culture as the reference standard. The panel identified seven additional pathogens not detected by conventional culture methods: 2/9 MSSA (22%), 1/1 (100%), and 4/11 (37%), increasing the yield by 14%. The rapid identification of pathogens facilitated timely and targeted therapeutic interventions.

CONCLUSIONS

The PCR multiplex panel (BioFire JI) improved the diagnosis of pediatric osteoarticular infections.

摘要

背景/目的:本研究旨在评估聚合酶链反应多重检测板(BioFire JI)对儿童骨关节炎感染诊断和管理的影响。

方法

这项回顾性研究分析了2023年1月至2024年4月期间被诊断为骨关节炎感染的儿科患者的数据。将聚合酶链反应多重检测板识别病原体的有效性与传统培养方法进行了比较。

结果

共确定了50例患者(66.6%为男性,74%年龄在3岁以下)。他们的诊断如下:化脓性关节炎占46%,骨髓炎占26%,化脓性骨关节炎占22%。通过传统培养在22例(44%)中分离出可识别的病原体。 是鉴定出的主要病原体,占病例的50%(11/22),其次是 (9/22)。以滑膜液培养作为参考标准进行评估时,BioFire JI检测板聚合酶链反应显示敏感性为93%,特异性为63%。该检测板还识别出了7种传统培养方法未检测到的病原体:2/9耐甲氧西林金黄色葡萄球菌(22%)、1/1 (100%)和4/11 (37%),使检出率提高了14%。病原体的快速鉴定有助于及时进行有针对性的治疗干预。

结论

聚合酶链反应多重检测板(BioFire JI)改善了儿童骨关节炎感染的诊断。

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本文引用的文献

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Guideline for management of septic arthritis in native joints (SANJO).原发性关节化脓性关节炎(SANJO)管理指南
J Bone Jt Infect. 2023 Jan 12;8(1):29-37. doi: 10.5194/jbji-8-29-2023. eCollection 2023.

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