Department of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Front Cell Infect Microbiol. 2020 Sep 17;10:471. doi: 10.3389/fcimb.2020.00471. eCollection 2020.
To evaluate metagenomic next-generation sequencing (mNGS) as a diagnostic tool in detecting pathogens from osteoarticular infection (OAI) samples. 130 samples of joint fluid, sonicate fluid, and tissue were prospectively collected from 92 patients with OAI. The performance of mNGS and microbiology culture was compared pairwise. The overall sensitivity of mNGS was 88.5% (115/130), significantly higher than that of microbiological culture, which had a sensitivity of 69.2% (90/130, < 0.01). Sensitivity was significantly higher for joint fluid (mNGS: 86.7% vs. microbiology culture: 68.7%, < 0.01) and sonicate fluid (mNGS: 100% vs. microbiology culture: 66.7%, < 0.05) samples. mNGS detected 12 pathogenic strains undetected by microbiological culture. Additional pathogens detected by mNGS were ( > 0.05), and (OR = ∞, 95% confidence interval, 5.12-∞, < 0.001). Additionally, sensitivity by mNGS was higher in antibiotic-treated samples compared to microbiological culture (89.7 vs. 61.5%, < 0.01). mNGS is a robust diagnostic tool for pathogenic detection in samples from OAI patients, compared to routine cultures. The mNGS technique is particularly valuable to diagnose pathogens that are difficult to be cultured, or to test samples from patients previously treated with antibiotics.
评估宏基因组下一代测序（mNGS）作为一种诊断工具，用于检测骨关节炎感染（OAI）样本中的病原体。前瞻性收集了 92 例 OAI 患者的关节液、超声液和组织样本 130 份。比较了 mNGS 和微生物培养的性能。mNGS 的总体灵敏度为 88.5%（115/130），明显高于微生物培养的 69.2%（90/130，<0.01）。关节液（mNGS：86.7% vs. 微生物培养：68.7%，<0.01）和超声液（mNGS：100% vs. 微生物培养：66.7%，<0.05）样本的灵敏度明显更高。mNGS 检测到 12 株微生物培养未检出的致病性菌株。mNGS 还检测到其他病原体，包括 （>0.05）和 （OR=∞，95%置信区间，5.12-∞，<0.001）。此外，与微生物培养相比，mNGS 对接受抗生素治疗的样本的灵敏度更高（89.7% vs. 61.5%，<0.01）。与常规培养相比，mNGS 是一种用于检测 OAI 患者样本中病原体的强大诊断工具。mNGS 技术对于诊断难以培养的病原体或检测接受过抗生素治疗的患者的样本特别有价值。
