The Comparison of Diagnostic Performance Between Next-Generation Sequencing of Blood and Tissues for Primary Spinal Infections.

Study designprospective study.ObjectivesThe hematogenous spread of pathogens from a distant infected area is the main route of primary spinal infections. It is expected that blood metagenomic next-generation sequencing (mNGS) has potential in the pathogen detection of primary spinal infections. The aim of this study is to compare the diagnostic performance of blood and tissue mNGS in primary spinal infections.MethodsA total of 21 patients with primary spinal infections were analyzed. The results of mNGS and culture of blood and spinal specimens were used to calculate the diagnostic efficiency-related parameters.ResultsThe positive rate, sensitivity and specificity of blood mNGS were significantly lower than those of tissue mNGS (42.86% vs 90.48%, 9.52% vs 95%, 12.5% vs 100%). The positive rate and sensitivity of blood mNGS were higher (42.86% vs 4.76, 9.52% vs 5%) than those of blood pathogen culture. Also, the sensitivity and specificity of blood mNGS were lower than tissue pathogen culture (9.52% vs 45%, 12.5% vs 100%). Moreover, the specificity of blood mNGS was the lowest among the 4 pathogen identification techniques.ConclusionsThe diagnostic performance of blood mNGS is worse than tissue mNGS in primary spinal infections. The application prospects of blood mNGS in pathogen identification of primary spinal infections are limited. Further studies will be required to investigate the diagnostic values of blood mNGS in other types of spinal infections or in subpopulations of spinal infections.