Ma Chiyuan, Wu Haobo, Chen Gang, Liang Chengzhen, Wu Lingyun, Xiao Yuxiang
Department of Orthopedics Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People's Republic of China.
Orthopedics Research Institute of Zhejiang University, Zhejiang Province, Hangzhou, People's Republic of China.
Eur Spine J. 2022 Feb;31(2):442-447. doi: 10.1007/s00586-021-07026-5. Epub 2021 Oct 22.
Metagenomic next-generation sequencing (mNGS) is a new approach to identify the infecting organism in infectious diseases. Our aim was to evaluate the accuracy of mNGS in determining the etiology of spinal infection.
In this retrospective study, patients who had a suspected spinal infection and underwent mNGS for diagnosis in our hospital were eligible for inclusion. Samples for mNGS, culture, and histopathological tests were collected surgically or with a CT-guided needle biopsy. Sensitivity and specificity were calculated for mNGS and culture test, using histopathological results as reference.
A total of 31 mNGS tests in 30 cases were included. Twenty-six cases were classified as infected, and four cases were considered aseptic. mNGS achieved a specificity of 75.0% [95% confidence interval (CI), 21.9% to 98.7%], sensitivity was 70.3% (95% CI, 49.7% to 85.5%). mNGS was more sensitive than culture at 14.8% (95% CI, 4.9% to 34.6%, P < 0.0001). However, the specificities of mNGS and culture were statistically similar.
We described here the power of mNGS in the etiological diagnosing of spinal infection. Our study opens the possibility for more extensive use of mNGS techniques in the identification of pathogens in patients with suspected spinal infection.
宏基因组下一代测序（mNGS）是一种鉴定感染性疾病中感染病原体的新方法。我们的目的是评估mNGS在确定脊柱感染病因方面的准确性。
在这项回顾性研究中，纳入了我院疑似脊柱感染并接受mNGS诊断的患者。通过手术或CT引导下穿刺活检收集用于mNGS、培养和组织病理学检查的样本。以组织病理学结果为参照，计算mNGS和培养检查的敏感性和特异性。
共纳入30例患者的31次mNGS检测。26例被分类为感染性，4例被认为是无菌性的。mNGS的特异性为75.0%[95%置信区间（CI），21.9%至98.7%]，敏感性为70.3%（95%CI，49.7%至85.5%）。mNGS比培养更敏感，差异为14.8%（95%CI，4.9%至34.6%，P < 0.0001）。然而，mNGS和培养的特异性在统计学上相似。
我们在此阐述了mNGS在脊柱感染病因诊断中的作用。我们的研究为在疑似脊柱感染患者中更广泛地使用mNGS技术来鉴定病原体开辟了可能性。
