广谱聚合酶链反应与宏基因组下一代测序在人工关节感染诊断中的比较。
Comparison of broad-range polymerase chain reaction and metagenomic next-generation sequencing for the diagnosis of prosthetic joint infection.
机构信息
Department of Orthopedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China.
Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China.
出版信息
Int J Infect Dis. 2020 Jun;95:8-12. doi: 10.1016/j.ijid.2020.03.055. Epub 2020 Apr 3.
PURPOSE
The aims of our study were to (1) evaluate the concordance of both methods for detecting prosthetic joint infection (PJI) pathogens in joint fluid and to (2) clarify whether broad-range polymerase chain reaction (BR-PCR) can be used as a verification method for metagenomic next-generation sequencing (mNGS) for PJI diagnosis.
METHODS
In total, 63 patients underwent total joint arthroplasty, with 45 PJI and 18 aseptic failure patients included. Joint fluids were sampled after antibiotics were withheld for more than 2 weeks, and then, culture, BR-PCR and mNGS were performed for all samples.
RESULTS
The joint fluid BR-PCR sensitivity was 82.2%, which was not significantly different from that of mNGS (95.6%) or culture (77.8%). The specificities of the 3 methods were all 94.4%. BR-PCR failed to identify the pathogens in 1 polymicrobial infection patient and 4 fungal infection patients.
CONCLUSION
mNGS was more sensitive than BR-PCR for detecting PJI pathogens in joint fluid. BR-PCR is insufficient for use as an mNGS verification method.
目的
我们研究的目的是：(1) 评估两种方法在检测关节液中人工关节感染（PJI）病原体时的一致性；(2) 阐明是否可以将广谱聚合酶链反应（BR-PCR）用作用于 PJI 诊断的宏基因组下一代测序（mNGS）的验证方法。
方法
共有 63 例患者接受了全关节置换术，其中包括 45 例 PJI 和 18 例无菌失败患者。在停止使用抗生素超过 2 周后采集关节液样本，然后对所有样本进行培养、BR-PCR 和 mNGS。
结果
关节液 BR-PCR 的灵敏度为 82.2%，与 mNGS（95.6%）或培养（77.8%）无显著差异。3 种方法的特异性均为 94.4%。BR-PCR 未能识别 1 例混合感染患者和 4 例真菌感染患者的病原体。
结论
mNGS 比 BR-PCR 更敏感地检测关节液中的 PJI 病原体。BR-PCR 不足以作为 mNGS 的验证方法。
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