Bone and Joint Infections, commonly known as osteoarticular infections or septic arthritis (also known as native joint infections), are infections that may involve both the bone and the adjacent joint. They are medical emergencies which can occur at all ages, and can lead to functional joint impairment, long-lasting disability, and may even be life-threatening. While they can be caused by various pathogens, bacterial infections are the most common. Staphylococcus aureus is the leading bacterium responsible for joint infections, accounting for more than 50% of these infections.¹ Reliable documentation of Bone and Joint Infection can be provided on a limited number of clinical samples: intra-articular puncture, preoperative arthrocentesis, intra-operative sampling, and blood cultures.

Bone and Joint infections cause a tremendous burden for patients and society.^2,3 Septic arthritis is a medical emergency requiring prompt diagnosis and treatment. Delayed diagnosis is associated with permanent disability and increased mortality, which can be as high as 15%.⁴

Additionally, Prosthetic Joint Infections (PJIs) are costly to treat and on the rise.⁵ As the number of joint replacement surgeries increase globally, the number of prosthetic joint infections is also rising. The cost to treat a PJI is 3 to 6 times more expensive than the initial arthroplasty.⁵ When missed or undertreated, PJIs can lead to unnecessary surgical revisions causing poor function or disability, considerably impacting quality of life.⁶  Bone and Joint Infections on equipment remain a major public health problem in terms of cost and morbidity.

Optimal treatment of BJIs depends on rapid and accurate diagnosis. Unfortunately, traditional diagnosis of these types of infections is complicated, as bone and joint diagnostics lack standardization of specimen type and preparation, test media, and methods.⁵  Culture negative PJIs occur in up to 35% of infections.⁷ Many BJIs are associated with difficult fastidious organisms, anaerobes, biofilm-forming organisms, and polymicrobial specimens, making it challenging to diagnose.⁵ Conventional testing for BJIs is complex, often requiring multiple patient samples, various send-out tests, and days of waiting for results, which then contributes to raising costs and compromised patient care. 

The threat of Methicillin-resistant Staphylococcus aureus (MRSA) is also a prime concern as it relates to surgical site infection (SSI) after orthopedic surgeries, especially with the increased number of joint replacement surgeries performed each year. The burden of MRSA in healthcare is significant as it leads to increased healthcare costs, antibiotic resistance, increased morbidity and mortality, transmission, and outbreak. To address the burden of MRSA on healthcare, prevention, screening, and control strategies are essential.

What if there was a tool that was faster than traditional methods, had improved diagnostic yield, and contributed to pathogen guided patient management for bone and joint infections? 

The BIOFIRE^® Joint Infection (JI) Panel is a rapid syndromic test that delivers comprehensive results in one easy-to-read report. It uses Multiplex Polymerase Chain Reaction (PCR) technology that offers a rapid sample-to-answer turnaround without sacrificing performance. The BIOFIRE^® JI Panel can aid in appropriate surgical decision making and reduce time to effective therapy through rapid pathogen identification.

Additionally, we offer chromogenic media for the direct identification of MRSA in patients who are chronic carriers or considered “at-risk,” such as patients undergoing surgery like a knee replacement. These patients can be screened at admission and during their hospital stay, which provides critical information for improved patient care, effective infection control, and outbreak management.

bioMérieux offers solutions for both pathogen and AMR identification as well as MRSA prevention screening associated with bone and joint infections.