Validation of a novel molecular diagnostic panel for pediatric musculoskeletal infections: Integration of the Cepheid Xpert MRSA/SA SSTI and laboratory-developed real-time PCR assays for clindamycin resistance genes and Kingella kingae detection

Potential Clinical Effects of a Novel Rapid Diagnostic Panel for Pediatric Musculoskeletal Infections

“…All bone and joint specimens from the included patients were tested using the 3 components of the MDP [6]. A retrospective review of patient charts was managed alongside MDP results using a REDCap electronic data-capture tool hosted at Children' s Hospital Colorado [7].…”

“…Details of the study population and the MDP were published previously [6]. In brief, the MDP combines 3 separate rapid tests, including the Xpert MRSA/SA SSTI assay, which identifies the presence of Staphylococcus aureus and genotypic methicillin resistance directly from a specimen, polymerase chain reaction (PCR) assays for the ermA, ermB, and ermC genes, which encode genotypic clindamycin resistance, and a Kingella kingae PCR assay, which targets the rtxA gene [6]. Turnaround times from bone or joint specimen collection until reporting of results were estimated to be 3 hours for the Xpert MRSA/SA SSTI results and 2:00 pm the following calendar day for the ermA/ermB/ermC gene and K kingae PCR assays.…”

“…Pathogen identification for musculoskeletal infections enables targeted antimicrobial therapy but currently relies on traditional time-intensive bacterial culture techniques [3][4][5]. We recently validated a novel rapid musculoskeletal diagnostic panel (MDP) [6]. The purpose of this study was to quantify the potential clinical effects of this new diagnostic tool.…”

Challenging Methicillin Resistance Detection in Bone and Joint Infections: Focus on the MRSA/SA SSTI® Strategy

“…Four out of seven were prospective studies; all but one (17) were led on adult cohorts. These studies were mainly conducted on PJI patients (18)(19)(20)(21); unspecified BJI (22); a combination between PJI, spondylodiscitis, and septic arthritis (23); and children suffering from musculoskeletal infections (17). The number of patients included varied from 30 to 213 patients tested for one (21) to at least three distinct samples (18,19), including joint aspiration, tissue or bone specimens, and prosthetic sonicates in one case (21).…”

<p>Acute Hematogenous Osteomyelitis in Children: Clinical Presentation and Management</p>

“…A number of multiplex PCR-based panels exist to help identify major AHO pathogens from either bone exudates, purulent collections or synovial fluid; in some cases, these studies are able to identify select antibiotic resistance genes. 29 Notably, a number of studies have illustrated that the use of PCR-based assays increases the rates of K. kingae identification by 2-4 fold. 30,31 In one series, 89% of cases of K. kingae musculoskeletal infection were diagnosed by molecular methods alone.…”