Evidence map›Paper›PMID 39849638›Full record

ArticlePediatric rheumatology online journal2025

Joint fluid multi-omics improves diagnostic confidence during evaluation of children with presumed septic arthritis.

Yolanda Peña-López, Naureen G Tareen, Bo Zhang, Indu Raman, Carlos A Arana, Chengsong Zhu, Yang Liu, Pratibha Selvakumar, Nicolai S C van Oers, Simrat Morris and 3 more

Abstract read
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In one paragraph

Article in Pediatric rheumatology online journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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5 · Who and what money

Authors and funding

13 authors.

Yolanda Peña-LópezDepartment of Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Naureen G TareenDepartment of Pediatric Orthopaedic Surgery, Children's Health System of Texas, Dallas, TX, USA.
Bo ZhangDepartment of Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Indu RamanDepartment of Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Carlos A AranaDepartment of Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Chengsong ZhuDepartment of Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Yang LiuDepartment of Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Pratibha SelvakumarDepartment of Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Nicolai S C van OersDepartment of Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Simrat MorrisDivision of Rheumatology, Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, USA.
Lora V HooperDepartment of Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Lawson A B CopleyDepartment of Pediatric Orthopaedic Surgery, Children's Health System of Texas, Dallas, TX, USA.
Prithvi RajDepartment of Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA. prithvi.raj@utsouthwestern.edu.

Funding

Hartwell Foundation Biomedical award 2020
6 · The paper itself

Abstract

backgroundAn accurate diagnosis of septic versus reactive or autoimmune arthritis remains clinically challenging. A multi-omics strategy comprising metagenomic and proteomic technologies were undertaken for children diagnosed with presumed septic arthritis to advance clinical diagnoses and care for affected individuals.

methodsTwelve children with suspected septic arthritis were prospectively enrolled to compare standard of care tests with a rapid multi-omics approach. The multi-omics combined bacterial 16S rRNA metagenomics, single cell transcriptomics, and proteomics on knee joint fluid specimens. The diagnostic value of the multi-omics was ascertained relative to standard of care culture and PCR-negative results.

resultsTen children with suspected primary septic arthritis and two with acute hematogenous osteomyelitis (AHO) diagnoses were assessed. Joint fluid bacterial cultures were positive for 6/12 (50%) patients, consistent with elevated inflammatory markers (IL-4, IL-6, IL-17A, TNF-a, etc.). Metagenomic bacterial sequencing results were 100% concordant with the culture results. Six patients were culture- and PCR-negative. Multiomics analyses of the 6 culture negative patients established that 2/6 culture-negative children had inflammatory arthritis with potential Juvenile idiopathic arthritis (JIA) and 1 had post-Streptococcal Reactive Arthritis. The children without any bacteremia had autoantibodies (IgGs) in the joint-fluid targeting several nuclear antigens (i.e., dsDNA, histones, Jo-1, scl-70, Ro/SS-A, SmDs, CENP-A along with non-nuclear antigens i.e. Albumin, Collagens, Myosin, Laminin, etc. Single cell transcriptomics confirmed an abundance of CD4

conclusionsThe multiomics approach rapidly identified children with bacterial or autoimmune inflammatory conditions, improving diagnostic and treatment strategies for those with presumptive septic arthritis.

Indexed as

Arthritis, InfectiousMetagenomicsProteomicsSynovial FluidAdolescentArthritis, JuvenileChildChild, PreschoolFemaleHumansMaleMultiomicsOsteomyelitisProspective StudiesRNA, Ribosomal, 16SRNA, Ribosomal, 16S16S rRNA bacterial sequencingAutoimmuneCytokine InfectionMetagenomicsNext-generation sequencing (NGS)PediatricSeptic arthritis; Streptococcus

Identifiers

PMID39849638
PMCPMC11759420

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