Articles | Volume 10, issue 6
https://doi.org/10.5194/jbji-10-437-2025
© Author(s) 2025. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-10-437-2025
© Author(s) 2025. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Original full-length article
| 
05 Nov 2025
Original full-length article |
| 05 Nov 2025
| 05 Nov 2025
Rapid pathogen detection in synovial fluid of acute native joint infections in adults: a clinical evaluation of a novel automated multiplex polymerase chain reaction (mPCR) system
Lukas Rabitsch
Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
Markus Luger
Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
Felix Lötsch
Division of Clinical Microbiology, Department of Laboratory Medicine, Comprehensive Centre for Infection Medicine, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
Peter Starzengruber
Division of Clinical Microbiology, Department of Laboratory Medicine, Comprehensive Centre for Infection Medicine, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
Florian Thalhammer
Department of Urology, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
Reinhard Windhager
Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
Birgit Willinger
Division of Clinical Microbiology, Department of Laboratory Medicine, Comprehensive Centre for Infection Medicine, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
Irene Katharina Sigmund
CORRESPONDING AUTHOR
Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
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Sinus tracts communicating with the prosthesis demonstrated high specificity and support their use as a confirmatory criterion for periprosthetic joint infection (PJI). Purulence also showed high specificity but may be better considered to be a suggestive criterion due to challenges in clinical differentiation. Both findings were associated with distinct microbiological patterns and less favourable outcomes, highlighting their clinical relevance.
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Sinus tracts communicating with the prosthesis demonstrated high specificity and support their use as a confirmatory criterion for periprosthetic joint infection (PJI). Purulence also showed high specificity but may be better considered to be a suggestive criterion due to challenges in clinical differentiation. Both findings were associated with distinct microbiological patterns and less favourable outcomes, highlighting their clinical relevance.
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This article outlines 20 common errors in the prevention, diagnosis, and management of fracture-related infection (FRI), highlighting their clinical consequences and providing practical recommendations for avoiding them. By addressing typical pitfalls and emphasizing standardized procedures and interdisciplinary collaboration, the article aims to improve patient safety and treatment outcomes.
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Laura K. Certain and Irene K. Sigmund
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The Musculoskeletal Infection Society (MSIS) and the European Bone and Joint Infection Society (EBJIS) are comprised of experts in preventing, diagnosing, and managing orthopedic infections. In 2023, MSIS and EBJIS surveyed their membership about their approach to various clinical aspects of these challenging conditions. The results indicate that, even among experts, there remains substantial variability of practice. This variability reflects open questions in the field.
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This is a summary of our position paper on debridement, antimicrobial therapy, and implant retention (DAIR) procedures as a curative treatment strategy for acute periprosthetic hip and knee infections. It includes the defined indications as well as the contraindications of DAIR procedures when eradication/cure is intended, based on the currently available literature.
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In this paper, we discuss the most relevant factors influencing the outcome and define indications, contraindications, and risk factors of a DAIR procedure based on the currently available literature. Furthermore, we discuss the surgical technique in combination with systemic antimicrobial therapy in patients undergoing a DAIR procedure.
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This study conducted in multiple sites across Europe aimed to evaluate the BIOFIRE Joint Infection (JI) Panel, a new technology that uses multiplex PCR to detect microorganisms in synovial fluid of patients with suspicion of joint infections in 1 h, in comparison with synovial fluid culture. Results showed an overall agreement of 85 % to 88.4 % between the two methods. The JI Panel detected additional organisms, and the positive user experience highlights its clinical significance.
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Short summary
The novel multiplex polymerase chain reaction (mPCR), BioFire® Joint Infection Panel (BF-JIP; bioMérieux, Marcy-l’Étoile, France), demonstrated similar diagnostic accuracy to conventional synovial fluid culture and can therefore serve as a valuable adjunct in diagnosing septic arthritis in adults, particularly in patients with prior antimicrobial therapy.
The novel multiplex polymerase chain reaction (mPCR), BioFire® Joint Infection Panel (BF-JIP;...
