{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T19:54:06Z","timestamp":1790970846440,"version":"4.1.0"},"reference-count":33,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"EU","award":["PE00000007"],"award-info":[{"award-number":["PE00000007"]}]},{"name":"ANIA","award":["PE00000007"],"award-info":[{"award-number":["PE00000007"]}]},{"name":"Italian Ministry of Health","award":["PE00000007"],"award-info":[{"award-number":["PE00000007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Paediatric osteoarticular infections (POAIs) present unique diagnostic and therapeutic challenges. Microbiological culture (MC) is typically time-consuming and lacks sensitivity, especially when patients have received antibiotics. The BIOFIRE\u00ae Joint Infection Panel (BJIP) is a syndromic molecular assay for the direct identification of most pathogens causing POAIs. Methods: We evaluated BJIP in 17 synovial fluids, and then, we retrospectively assessed its utility in 93 off-label specimens (i.e., 25 purulent fluids\/biopsies and 68 whole blood samples). All specimens were collected from October 2022 to March 2024 from paediatric patients admitted at the Bambino Ges\u00f9 Children\u2019s Hospital in Rome. Results: A bacterial pathogen was isolated in only one of 17 synovial fluid cultures, while BJIP identified eight additional microorganisms in MC-negative cases. The most frequently detected pathogen was S. aureus (44.5%, 4\/9). BJIP performance in synovial fluids showed an overall positive percentage agreement (PPA) and negative percentage agreement (NPA) of 100% and 88.1%, respectively, compared to MC. All positive results (n\/N = 9\/17) were considered medically significant, with an increase in NPA to 100%. In purulent fluids\/biopsies, BJIP and MC were concordant in 72% of cases (n\/N = 18\/25), with a per-sample PPA and NPA of 90% and 60%, respectively. For whole blood samples, almost all samples were negative by both methods (i.e., reference blood culture and BJIP), and the molecular test did not enable any further microbiological diagnosis. Conclusions: The BIOFIRE\u00ae Joint Infection Panel rapidly and accurately enabled or excluded a diagnosis of a POAI (~1 vs. 24\u201396 h for MC), optimising antimicrobial therapy.<\/jats:p>","DOI":"10.3390\/diagnostics15050566","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T08:28:31Z","timestamp":1740558511000},"page":"566","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["An Evaluation of a Syndromic Molecular Panel in Optimising the Microbiological Diagnosis and Antimicrobial Therapy of Suspected Osteoarticular Infections in Paediatric Patients"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6017-3232","authenticated-orcid":false,"given":"Marilena","family":"Agosta","sequence":"first","affiliation":[{"name":"Microbiology and Diagnostic Immunology Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7129-9001","authenticated-orcid":false,"given":"Venere","family":"Cortazzo","sequence":"additional","affiliation":[{"name":"Microbiology and Diagnostic Immunology Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Onori","sequence":"additional","affiliation":[{"name":"Microbiology and Diagnostic Immunology Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Lucignano","sequence":"additional","affiliation":[{"name":"Microbiology and Diagnostic Immunology Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6906-9506","authenticated-orcid":false,"given":"Gianluca","family":"Vrenna","sequence":"additional","affiliation":[{"name":"Multimodal Laboratory Medicine, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5331-3973","authenticated-orcid":false,"given":"Martina","family":"Rossitto","sequence":"additional","affiliation":[{"name":"Multimodal Laboratory Medicine, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3273-6002","authenticated-orcid":false,"given":"Maria del Carmen","family":"Pereyra Boza","sequence":"additional","affiliation":[{"name":"Microbiology and Diagnostic Immunology Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4552-8461","authenticated-orcid":false,"given":"Valeria","family":"Fox","sequence":"additional","affiliation":[{"name":"Multimodal Laboratory Medicine, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Roversi","sequence":"additional","affiliation":[{"name":"PhD Program in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3316-957X","authenticated-orcid":false,"given":"Antonio","family":"Musolino","sequence":"additional","affiliation":[{"name":"Residency School of Pediatrics, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Krzysztofiak","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Immunoinfectivology Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Lancella","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Immunoinfectivology Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9646-8892","authenticated-orcid":false,"given":"Marco","family":"Giordano","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCSS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Falciglia","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCSS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5931-8679","authenticated-orcid":false,"given":"Ottavia","family":"Porzio","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9120-0424","authenticated-orcid":false,"given":"Alberto","family":"Villani","sequence":"additional","affiliation":[{"name":"General Pediatric and Infectious Disease Unit, Pediatric Emergency Medicine, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo Federico","family":"Perno","sequence":"additional","affiliation":[{"name":"Microbiology and Diagnostic Immunology Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Bernaschi","sequence":"additional","affiliation":[{"name":"Microbiology and Diagnostic Immunology Unit, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e108","DOI":"10.1097\/PEC.0000000000002045","article-title":"The Osteoarticular Infection in a Paediatric Emergency Setting: A Challenging Diagnosis","volume":"36","author":"Boccuzzi","year":"2020","journal-title":"Pediatr. 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