宏基因组下一代测序在侵袭性骨与关节感染病原体检测中的作用。
The role of metagenomic next-generation sequencing in the pathogen detection of invasive osteoarticular infection.
机构信息
Department of Orthopedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Department of Orthopedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China; Department of Orthopedic Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
出版信息
Int J Infect Dis. 2022 Sep;122:996-1001. doi: 10.1016/j.ijid.2022.07.061. Epub 2022 Jul 29.
OBJECTIVES
This study aimed to analyze the pathogenic bacteria spectrum in invasive and primary osteoarticular infection (IOI and POI) and compare the pathogen detection rate of metagenomic next-generation sequencing (mNGS) and microbial culture in IOI and POI.
METHODS
The suspected POI and IOI cases from 2014-2021 were included. The diagnosis of POI or IOI was made by at least two orthopedic surgeons, two infectious diseases specialists, and one senior microbiologist. Demographic characteristics, microbial culture results, and so on were recorded. The pathogenic bacteria spectrum in IOI and POI were analyzed, and the ability of mNGS and microbial culture in pathogen detection in IOI and POI were compared.
RESULTS
There were 52 POI cases and 92 IOI cases; the common pathogen in POI and IOI were both Staphylococcus aureus. There are more cases with negative microbial culture results and multiple infections in IOI, and many cases were caused by rare and fastidious bacteria. The introduction of the mNGS could significantly increase the pathogen detection rate to 92.39% in IOI, which was 8.69% higher than that of microbial culture (P = 0.007), whereas the improvement in POI was limited to about 2%.
CONCLUSION
mNGS is an promising tool for IOI pathogen detection.
目的
本研究旨在分析侵袭性和原发性骨与关节感染（IOI 和 POI）的病原菌谱，并比较宏基因组二代测序（mNGS）和微生物培养在 IOI 和 POI 中的病原体检测率。
方法
纳入 2014-2021 年疑似 POI 和 IOI 病例。至少由 2 名骨科医生、2 名传染病专家和 1 名高级微生物学家共同诊断 POI 或 IOI。记录人口统计学特征、微生物培养结果等。分析 IOI 和 POI 的病原菌谱，并比较 mNGS 和微生物培养在 IOI 和 POI 病原体检测中的能力。
结果
共纳入 52 例 POI 病例和 92 例 IOI 病例；POI 和 IOI 的常见病原体均为金黄色葡萄球菌。IOI 中微生物培养结果阴性和多种感染的病例更多，许多病例由罕见和苛刻的细菌引起。引入 mNGS 可显著提高 IOI 的病原体检测率，达到 92.39%，比微生物培养高 8.69%（P=0.007），而对 POI 的改善则限于 2%左右。
结论
mNGS 是 IOI 病原体检测的一种很有前途的工具。
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