Shi Tengfei, Lin Yuhan, Zheng Xuexin, Ruan Hongliang, Zhang Rui, Liu Yinhuan, Xu Shaohan, Wang Huafeng
Department of Clinical Laboratory, Fuzhou Second General Hospital, Fuzhou, Fujian, China.
Department of Spine Surgery, Fuzhou Second General Hospital, Fuzhou, Fujian, China.
Front Cell Infect Microbiol. 2025 Jan 7;14:1437665. doi: 10.3389/fcimb.2024.1437665. eCollection 2024.
This study aimed to evaluate the efficacy of metagenomic next-generation sequencing (mNGS) technology for identifying pathogens associated with spinal infection (SI).
A retrospective analysis was conducted on clinical data from 193 patients with suspected SI between August 2020 and September 2024. Based on histopathological results, the patients were divided into the SI group (n=162) and the non-SI group (n=31). The diagnostic performance of mNGS technology was compared with that of laboratory examination, imaging examination, and microbial culture.
Among SI group, mNGS detected 135 pathogens in 77.78% (126/162) of the cases, including nine cases of multiple infections. One or more pathogens were detected using mNGS in 86 patients with SI and negative microbial cultures. (22.22%, n=30) and (22.22%, n=30) were the major pathogens, while various rare pathogens such as anaerobes, , and were also detected. For the 40 cases with positive results for both culture- and mNGS-based identification, high consistency (77.50%) was observed. Antibiotic use did not significantly affect the mNGS detection rate (P = 0.45). There was no significant difference in the positivity rate of mNGS between CT-guided needle biopsy (80.00%) and surgical sampling (77.17%) (P = 0.72). The sensitivity of mNGS (77.78%) was significantly higher than that of traditional microbial culture (27.16%), and the specificity was similar (90.32% vs. 96.77%). Although the sensitivities of erythrocyte sedimentation rate-based assay (91.36%), magnetic resonance imaging (88.27%), and C-reactive protein-based assay (87.65%) were better than those of mNGS, their specificities were generally low (20%-40%).
The pathogens responsible for SI are complex and diverse. As a novel diagnostic method, mNGS exhibits a high sensitivity and extensive pathogen coverage for SI diagnosis. When combined with imaging and laboratory indicators, mNGS can significantly improve the accuracy of SI diagnosis and provide strong support for clinical treatment.
本研究旨在评估宏基因组下一代测序（mNGS）技术在识别与脊柱感染（SI）相关病原体方面的疗效。
对2020年8月至2024年9月期间193例疑似SI患者的临床资料进行回顾性分析。根据组织病理学结果，将患者分为SI组（n = 162）和非SI组（n = 31）。将mNGS技术的诊断性能与实验室检查、影像学检查和微生物培养的诊断性能进行比较。
在SI组中，mNGS在77.78%（126/162）的病例中检测到135种病原体，包括9例多重感染。在86例微生物培养阴性的SI患者中，mNGS检测到一种或多种病原体。（22.22%，n = 30）和（22.22%，n = 30）是主要病原体，同时还检测到各种罕见病原体，如厌氧菌、和。对于基于培养和mNGS鉴定均呈阳性结果的40例病例，观察到高度一致性（77.50%）。抗生素使用对mNGS检测率无显著影响（P = 0.45）。CT引导下穿刺活检（80.00%）和手术取样（77.17%）的mNGS阳性率无显著差异（P = 0.72）。mNGS的敏感性（77.7%）显著高于传统微生物培养（27.16%），特异性相似（90.32%对96.77%）。虽然基于红细胞沉降率的检测（91.36%）、磁共振成像（88.27%）和基于C反应蛋白的检测（87.65%）的敏感性优于mNGS，但其特异性普遍较低（20%-40%）。
导致SI的病原体复杂多样。作为一种新型诊断方法，mNGS在SI诊断中表现出高敏感性和广泛的病原体覆盖范围。当与影像学和实验室指标相结合时，mNGS可显著提高SI诊断的准确性，并为临床治疗提供有力支持。
