Zhang Nan, Ma Lei, Ding Wenyuan
Department of Spine Surgery, 3rd Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.
Int J Gen Med. 2023 Jan 5;16:37-45. doi: 10.2147/IJGM.S394255. eCollection 2023.
To determine the diagnostic value of blood next-generation sequencing (NGS) in early surgical site infection after spine surgery. Because the blood is sterile in healthy individuals, it is expected that blood NGS is both sensitive and specific for the detection of infection.
A total of 28 patients with definitive spinal surgical site infections and controls (n=30) were retrospectively included. The postoperative results of NGS and culture on different samples, such as blood and drainage fluid, were obtained and compared to evaluate the diagnostic value of blood NGS. The diagnostic value parameters (sensitivity, specificity, etc.) were calculated.
Among the four bacteriological exam methods, blood NGS was both sensitive and specific for the determination of infection after spine surgery. The sensitivities of blood and drainage fluid NGS were similar (0.82 vs 0.89, P=0.617). However, the specificities of the two assessments differed, which were 0.97 for blood NGS and 0.40 for drainage fluid NGS (P<0.001). The sensitivities of bacterial culture were lower than those of NGS (blood: 0.82 vs 0.25, P<0.001; drainage fluid: 0.89 vs 0.61, P<0.001), regardless of the sample type. However, the specificities of bacterial culture were equal to or higher than those of NGS (blood: 0.97 vs 0.97, P=1.000; drainage fluid: 0.40 vs 0.80, P=0.002).
This article emphasizes the superiority of blood NGS in infection detection and bacterial determination in patients undergoing spine surgery. Compared with traditional drainage fluid bacterial culture and NGS, blood NGS was more sensitive and specific, and its extensive application could be expected.
确定血液下一代测序（NGS）在脊柱手术后早期手术部位感染中的诊断价值。由于健康个体的血液是无菌的，因此预计血液NGS在检测感染方面既敏感又特异。
回顾性纳入28例确诊的脊柱手术部位感染患者及对照组（n = 30）。获取并比较血液和引流液等不同样本的NGS和培养术后结果，以评估血液NGS的诊断价值。计算诊断价值参数（敏感性、特异性等）。
在四种细菌学检查方法中，血液NGS在脊柱手术后感染的测定中既敏感又特异。血液和引流液NGS的敏感性相似（0.82对0.89，P = 0.617）。然而，两种评估的特异性不同，血液NGS为0.97，引流液NGS为0.40（P < 0.001）。无论样本类型如何，细菌培养的敏感性均低于NGS（血液：0.82对0.25，P < 0.001；引流液：0.89对0.61，P < 0.001）。然而，细菌培养的特异性等于或高于NGS（血液：0.97对0.97，P = 1.000；引流液：0.40对0.80，P = 0.002）。
本文强调了血液NGS在脊柱手术患者感染检测和细菌鉴定中的优势。与传统的引流液细菌培养和NGS相比，血液NGS更敏感、特异，有望得到广泛应用。
