Department of Infectious Diseases and Venhälsan, Södersjukhuset, Stockholm, Sweden.
Division of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
BMC Res Notes. 2022 Mar 22;15(1):113. doi: 10.1186/s13104-022-05992-7.
Clinicians worldwide struggle to identify the bacterial aetiology of bone and joint infections. Failure to unequivocally identify the pathogen is linked to poor clinical outcomes. We explored the added value of analysing multiple samples per patient with 16S ribosomal DNA (16S rDNA) sequencing in diagnosing postoperative bone and joint infections. All patients had received antimicrobials prior to sampling, and false-negative cultures could be suspected. Bone biopsies obtained from patients with postoperative bone and joint infections for cultures were also subjected to 16S rDNA sequencing.
In 5/28 infectious episodes, sequencing identified the causative organism of the infection when cultures failed. In 8/28 episodes, the methods led to different results, potentially leading to different antimicrobial choices. The analysis of multiple samples per patient helped rule out potential contaminating pathogens. We conclude that 16S rDNA sequencing has diagnostic value for patients receiving antibiotic treatment. We regard the method as a complement to culturing when the cultures are negative. Multiple samples per patient should be analysed to determine the clinical significance of positive findings.
全球临床医生在确定骨和关节感染的细菌病因方面存在困难。未能明确鉴定病原体与不良临床结局相关。我们探讨了对每个患者的多个样本进行 16S 核糖体 DNA（16S rDNA）测序，以诊断术后骨和关节感染的附加价值。所有患者在采样前均接受了抗菌药物治疗，可能存在假阴性培养。对术后骨和关节感染患者的骨活检标本进行培养的同时，也进行了 16S rDNA 测序。
在 28 次感染发作中，5 次测序结果在培养失败时确定了感染的病原体。在 28 次发作中，两种方法的结果不同，可能导致不同的抗菌药物选择。对每个患者的多个样本进行分析有助于排除潜在的污染病原体。我们得出结论，16S rDNA 测序对接受抗生素治疗的患者具有诊断价值。我们认为该方法是在培养结果为阴性时对培养的补充。应分析每个患者的多个样本，以确定阳性发现的临床意义。
