The Best Diagnostic Tools for Orthopedic Infection Patients

MicroGenDX OrthoKEY® offers the ideal synergy of evidence-based diagnostics for periprosthetic joint infection

 

qPCR vs NGS

MicroGenDX OrthoKEY PJI OR and OrthoKEY PJI Clinic offer you the essential diagnostic compliment to culture that combines biomarkers for infection with molecular analysis – at the lowest cost and fastest turnaround on the market.

In contrast to what actually grows in culture, next-generation sequencing (NGS) identifies both the growth potential of clinically relevant microbes in a sample, and the relative abundance of those microbes. NGS analysis was recommended by a 2018 International Consensus Meeting strong consensus for identifying culture-negative infections — which NGS identifies 80-90% of the time.

MicroGenDX’s NGS protocol includes both positive and negative controls. Positive controls consist of known species and predictable results that can be verified in each stage of the process — ensuring each stage is performed correctly. The negative control consists of sterile water, run as a parallel sample to confirm that no contamination has occurred during any stage of the process.

OrthoKEY PJI OR, peace of mind for revision procedures, includes:

  • Synovial biomarkers (CRP, WBC, PMN%) and antimicrobial resistance genes in 24-48 hours
  • NGS identification of microbes from synovial fluid, implant wipe-downs, and swabs in 3.5 days.
  • PJIDx diagnostic app — a guideline-based, AI-driven app provides probability of infection based on combined NGS and biomarker results

OrthoKEY PJI Clinic, taking the mystery out of in-clinic PJI diagnostics, includes:

  • Synovial biomarkers (CRP, WBC, PMN%) and antimicrobial resistance genes from aspiration sample in 24-48 hours
  • NGS identification of microbes from synovial fluid in 3.5 days
  • PJIDx diagnostic app

Total joint arthroplasty failure predicted by NGS in landmark prospective multicenter study

In 2020 a prospective multicenter study demonstrated that 68.6% of revision failures following two-stage exchange were due to untreated or undertreated pathogens that were missed by culture, but detected by NGS at the time of initial resection. Read about study

References

  1. Corona P S, et al. General Assembly, Diagnosis, Pathogen Isolation: Proceedings of International Consensus on Orthopedic Infections. The Journal of Arthroplasty. 34 (2019) S207eS214. https://doi.org/10.1016/j.arth.2018.09.072
  2. Ivy MI, Sharma K, Greenwood-Quaintance KE, Tande AJ, et al. Synovial fluid alpha defensin has comparable accuracy to synovial fluid white blood cell count and polymorphonuclear percentage for periprosthetic joint infection diagnosis. Bone Joint J 2021;103-B(6):1119–1126. doi: 10.1302/0301-620X.103B6.BJJ-2020-1741.R1
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