Program Schedule

707
Rapid Identification of Pathogens Causing Septic Arthritis using FilmArray®

Session: Poster Abstract Session: Approach to Clinical Infections
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • IDSA 2014 Poster (SA) Final.pdf (876.5 kB)
  • Background:

    Septic arthritis (SA) is a common and serious infection in children and can cause significant orthopedic morbidity. Bacteria are most often implicated, but routine cultures are frequently negative, because of prior antibiotics or delayed evaluation of joint fluid (JF). As such, children are treated with broad-spectrum antibiotics. A rapid molecular test that can identify the common bacteria causing joint infection could improve patient care. 

    Methods:

    The FilmArray® (FA) Blood Culture ID (BCID) System (BioFire Diagnostics, Inc., Salt Lake City, UT) performs nucleic acid purification and multiplex PCR to identify 22 bacterial pathogens in ~ 1 hour. The BCID system is approved only for use with positive blood cultures. Testing was performed on archived JF samples collected from children <18 years old with clinical signs and symptoms of SA at Primary Children’s Hospital (UT) from 10/2012 to 4/2014. FA identification was compared to conventional culture.

    Results:

    JF from 28 children with SA were evaluated. A bacteria was identified by culture (blood and/or JF) in 14 (50%) children, (JF-11 (39%), Blood-8 (29%)). By FA testing, a bacteria was identified in 14 (50%) JF. Of the 14 culture-identified pathogens, 13 (93%) were contained on the FA BCID panel, of which 11 (85%) were identified by FA testing of JF. 8 children had S. aureus identified by culture and 6 were identified by PCR of JF. Those not identified by the FA were identified by blood culture only. In addition, FA identified 3 additional pathogens in culture-negative JF; Haemophilus influenzae type a- 2 and H. influenzae type b- 1 (Table). 

    Conclusion:

    The FA BCID System is a novel tool for the rapid identification of bacterial pathogens. Our study demonstrates the potential utility of this system for the direct identification of pathogens from JF specimens. Rapid identification of pathogens from JF, including samples that are ultimately culture-negative, has the potential to improve the medical management of patients with septic arthritis.

    Pathogen

    Blood/JF Culture

    JF by FA testing

    S. aureus

    8 (7MSSA/1 MRSA)

    6 (5 MSSA/1 MRSA)

    Salmonella spp

    1

    1

    H. influenzae

    0

    3 (type a-2, type b-1)

    S. pyogenes

    2

    2

    S. pneumoniae

    1

    1

    E. faecalis

    1

    1

    S. moliniformis*

    1

    0

    No Pathogen Identified

    14

    14

    *Not included in FA BCIP panel

    Susan K. Sanderson, DNP1, Krow Ampofo, MD1, Jarrett Killpack, BSc1, Caroline Heyrend, PharmD1, Pricilla Cowan1, Chris Stockmann, MSc1, Judy Daly, PhD2 and Anne J. Blaschke, MD, PhD1, (1)Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT, (2)Microbiology, Primary Children's Medical Center, Salt Lake City, UT

    Disclosures:

    S. K. Sanderson, None

    K. Ampofo, None

    J. Killpack, None

    C. Heyrend, None

    P. Cowan, None

    C. Stockmann, None

    J. Daly, None

    A. J. Blaschke, BioFire Diagnostics LLC: Collaborator and Scientific Advisor, Co-Investigator on NIH grant, BioFire Principal Investigator, Consulting fee and Licensing agreement or royalty

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