{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:06Z","timestamp":1792785846861,"version":"4.5.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U01CK000480"],"award-info":[{"award-number":["U01CK000480"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016739","name":"BIOFIRE Diagnostics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016739","id-type":"DOI","asserted-by":"publisher"},{"id":"https:\/\/ror.org\/04k4ejz78","id-type":"ROR","asserted-by":"crossref"}]},{"name":"LLC"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Septic arthritis is an infectious disease emergency. Diagnosis is limited by low sensitivity of synovial fluid cell count and Gram stain and delayed culture results. The impact of polymerase chain reaction (PCR) testing on clinical care of patients suspected of septic arthritis is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective, observational study (2021\u20132023) at 9 US emergency departments (EDs) of adults evaluated for septic arthritis with synovial fluid culture and subsequent PCR testing of residual fluid. We report PCR concordance, sensitivity, and specificity compared to culture, 30-day diagnosis, and antibiotic delay &amp;gt;1 day and project the impact of point-of-care PCR results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 475 participants, 126 (26.5%) were diagnosed with septic arthritis. Eighty-eight (18.5%) had positive PCR and 80 (16.8%) had positive culture that identified, respectively, Staphylococcus aureus (36 [40.9%] vs 29 [36.3%]), streptococci (32 [36.4%] vs 22 [27.5%]), and Neisseria gonorrhoeae (12 [13.6%] vs 4 [5.0%]). PCR-culture concordance was 89.5%. For PCR-targeted organisms, PCR sensitivity and specificity were 89.2% (95% confidence interval [CI], 79.4%\u201394.7%) and 95.3% (95% CI, 92.5%\u201397.1%), respectively. Fifty-seven (45.2%) participants with septic arthritis had concordant positive PCR\/culture results; 11 (19.3%) had delayed treatment (1\u20136 days). Nineteen (15.1%) participants with septic arthritis had a PCR-positive\/culture-negative result, which occurred more frequently with antibiotic pretreatment and N. gonorrhoeae; all were treated empirically. Three participants with only PCR-detected N. gonorrhoeae did not receive treatment for the infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adjunctive point-of-care PCR testing is projected to improve the timeliness of ED septic arthritis diagnosis and pathogen-specific treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trials Registration<\/jats:title>\n                    <jats:p>NCT05341908<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag476","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:50:48Z","timestamp":1786535448000},"source":"Crossref","is-referenced-by-count":0,"title":["Performance and Projected Impact of Synovial Fluid Polymerase Chain Reaction Testing for Patients Evaluated for Septic Arthritis"],"prefix":"10.1093","author":[{"given":"Mark T","family":"Steele","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University Health\/University of Missouri\u2013Kansas City School of Medicine , Kansas City, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4450-2347","authenticated-orcid":false,"given":"Amy M","family":"Stubbs","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University Health\/University of Missouri\u2013Kansas City School of Medicine , Kansas City, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3503-3473","authenticated-orcid":false,"given":"Anusha","family":"Krishnadasan","sequence":"additional","affiliation":[{"name":"Olive View\u2013UCLA Education and Research Institute and the David Geffen School of Medicine, Department of Emergency Medicine, University of California , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie","family":"Kemble","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University Health\/University of Missouri\u2013Kansas City School of Medicine , Kansas City, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3945-7716","authenticated-orcid":false,"given":"Ruoyu","family":"Li","sequence":"additional","affiliation":[{"name":"Olive View\u2013UCLA Education and Research Institute and the David Geffen School of Medicine, Department of Emergency Medicine, University of California , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William R","family":"Mower","sequence":"additional","affiliation":[{"name":"Olive View\u2013UCLA Education and Research Institute and the David Geffen School of Medicine, Department of Emergency Medicine, University of California , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2493-2902","authenticated-orcid":false,"given":"Joseph","family":"Liao","sequence":"additional","affiliation":[{"name":"Olive View\u2013UCLA Education and Research Institute and the David Geffen School of Medicine, Department of Emergency Medicine, University of California , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1566-1668","authenticated-orcid":false,"given":"Gregory J","family":"Moran","sequence":"additional","affiliation":[{"name":"Olive View\u2013UCLA Education and Research Institute and the David Geffen School of Medicine, Department of Emergency Medicine, University of California , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7048-8086","authenticated-orcid":false,"given":"David A","family":"Talan","sequence":"additional","affiliation":[{"name":"Olive View\u2013UCLA Education and Research Institute and the David Geffen School of Medicine, Department of Emergency Medicine, University of California , Los Angeles, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"(co-senior authors) for the EMERGEncy ID NET Study 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