Metagenomic next generation sequencing improves diagnosis of prosthetic joint infection by detecting the presence of bacteria in periprosthetic tissues

Abstract

The purpose of this study was to explore the role of mNGS in the diagnosis of PJI by detecting the presence of bacteria in periprosthetic tissues. Methods: Patients who were suspected of PJI and underwent surgery in our center were enrolled. Microbial culture and mNGS were performed on periprosthetic tissues collected intraoperatively. Patient age, body mass index (BMI), laboratory tests, microbial culture and mNGS results were recorded. The diagnostic performance of microbial culture and mNGS in the diagnosis of PJI was compared. Results: A total of 44 patients were included. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of periprosthetic tissue microbial culture in the diagnosis of PJI were 72.72%, 77.27%, 76.19%, 73.91% and 75%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of periprosthetic tissue mNGS in the diagnosis of PJI were 95.45%, 90.91%, 91.3%, 95.24% and 93.18%, respectively. The sensitivity and specificity of mNGS in the diagnosis of PJI were superior to those of microbial culture. Conclusion: Periprosthetic tissue can be used as an alternative to synovial fluid and sonication fluid, as mNGS can improve the diagnosis of PJI. mNGS of the periprosthetic tissues showed higher sensitivity than microbial culture.

Exploring the Clinical Utility of Metagenomic Next-Generation Sequencing in the Diagnosis of Pulmonary Infection

“…Our results showed that the sensitivity of mNGS in pulmonary infection pathogen detection was much higher than that of the conventional test (89.17% vs 50.00%; P < 0.01), while the specificity of the conventional test was better than mNGS (81.82% vs 75.00%; P > 0.05). This outcome is inconsistent with the study by Cai et al, who found that the sensitivity and specificity of mNGS were both superior to those of culture [ 12 ]. However, another study showed that the specificity of mNGS and conventional test are nearly the same (95.2% and 95.2%, respectively; P = 1.0) [ 13 ].…”

Pathogenic Detection by Metagenomic Next-Generation Sequencing in Osteoarticular Infections

“…Raw sequencing data was analyzed by a bioinformatic pipeline developed by BGI (Cai et al, 2020 ), which included the following steps. (1) Short (length <35 bp) and low-quality reads were filtered.…”

“…The coverage rate was defined as number of matched reads ×50/genome length. Optimal thresholds were set up as below in order to identify true pathogens using previously studied data (Cai et al, 2020 ).…”

Case Report: Fascioliasis Hepatica Precisely Diagnosed by Metagenomic Next-Generation Sequencing and Treated With Albendazole

“…The suspected pathogen can be detected by the mNGS, through the flow of sequencing, data cleaning, error detection, and database comparative analysis. At present, mNGS has been widely used in clinics, including, respiratory tract infection ( 25 ), central nervous system infection ( 26 ), joint infection ( 27 , 28 ), hepatic tuberculosis ( 29 ), etc. Metagenomic next-generation sequencing has many advantages in identifying hard-to-culture, atypical, parasite, and rare pathogens, such as Mycobacterium Tuberculosis and Toxoplasma gondii .…”