Department of Clinical Pharmacy, Honghui Hospital, Xi'an Jiaotong University, Xi'an, People's Republic of China.
Int Wound J. 2023 Aug;20(6):2121-2128. doi: 10.1111/iwj.14087. Epub 2023 Jan 17.
To investigate the application value of next-generation sequencing (NGS) technology in the detection of pathogenic bacteria in the periprosthetic joint infection after arthroplasty. Twenty-two cases of patients with joint infection after arthroplasty in our hospital from March 2020 to March 2021 were selected, with 11 cases of knee and 11 cases of hip, including 8 cases of male and 14 cases of female, and an average age of 63.55 ± 13.11 years old (range from 28 to 85). Microbiological culture results of synovial fluid and periprosthetic joint tissue and NGS results of periprosthetic joint tissue were collected. The detection rate of NGS and microbiological culture were calculated and statistically analysed by paired χ test. Among the 22 patients with joint infection after arthroplasty, the positive rate of NGS was 90.91% (20/22), whereas the positive rate of bacterial culture was 50.00% (11/22). Paired chi-square test showed a statistically significant difference in the detection rate between the two groups (P = .0029). In the detection of pathogenic microorganism, NGS detected 12 kinds of bacteria, Staphylococcus aureus in 3 patients, Staphylococcus epidermidis in 5 cases, Streptococcus 1 case, Streptococcus dysgalactiae 1 case, Xanthomonas campestris 3 cases, Escherichia coli 2 cases, Bacillus cereus 2 cases, Klebsiella pneumoniae 1 case, Finegoldia magna 1 case, Corynebacterium klopensteriella in 1 case, Brucella 1 case, and Aspergillus flavus 1 case. Bacterial culture detected 6 kinds of bacteria, included 5 cases of Staphylococcus epidermis (including 3 cases of Methicillin-resistant coagulase-negative Staphylococcus, (MRSCoN)), 2 cases of Staphylococcus aureus (both Methicillin-resistant Staphylococcus aureus, (MRSA)), 1 case of Klebsiella pneumoniae, 1 case of Staphylococcus hominis (MRSCoN), 1 case of G bacillus, and 1 case of Brucella. Compared with bacterial culture, NGS technology has some advantages in the detection efficiency, detection rate, and comprehensiveness, which might be greater diagnostic value in the joint fluid of infection after arthroplasty.
探讨下一代测序（NGS）技术在检测关节置换术后假体周围关节感染中的应用价值。选取我院 2020 年 3 月至 2021 年 3 月收治的 22 例关节置换术后关节感染患者，其中膝关节 11 例，髋关节 11 例，男 8 例，女 14 例，年龄 63.55±13.11 岁（28～85 岁）。收集关节液和假体周围组织的微生物培养结果和假体周围组织的 NGS 结果，采用配对 χ检验计算 NGS 和微生物培养的检出率，并进行统计学分析。22 例关节置换术后关节感染患者中，NGS 阳性率为 90.91%（20/22），细菌培养阳性率为 50.00%（11/22）。配对 χ检验显示两组检出率差异有统计学意义（P=0.0029）。在检测病原体微生物方面，NGS 检测到 12 种细菌，3 例金黄色葡萄球菌，5 例表皮葡萄球菌，1 例链球菌，1 例停乳链球菌，3 例野油菜黄单胞菌，2 例大肠埃希菌，2 例蜡样芽孢杆菌，1 例肺炎克雷伯菌，1 例金葡菌，1 例棒状杆菌，1 例布鲁菌，1 例黄曲霉菌。细菌培养检测到 6 种细菌，包括 5 例表皮葡萄球菌（3 例耐甲氧西林凝固酶阴性葡萄球菌（MRSCoN）），2 例金黄色葡萄球菌（均为耐甲氧西林金黄色葡萄球菌（MRSA）），1 例肺炎克雷伯菌，1 例人葡萄球菌（MRSCoN），1 例 G 杆菌，1 例布鲁菌。与细菌培养相比，NGS 技术在检测效率、检出率和全面性方面具有一定优势，可能对关节置换术后关节液感染具有更大的诊断价值。
