Chao-Xin Wang1, Zida Huang1, Xinyu Fang1, Wenbo Li1, Bin Yang2, Wenming Zhang3. 1. Department of Orthopedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China. 2. Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China. 3. Department of Orthopedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China. Electronic address: zhangwm0591@fjmu.edu.cn.
Abstract
PURPOSE: The aims of our study were to (1) evaluate the concordance of both methods for detecting prosthetic joint infection (PJI) pathogens in joint fluid and to (2) clarify whether broad-range polymerase chain reaction (BR-PCR) can be used as a verification method for metagenomic next-generation sequencing (mNGS) for PJI diagnosis. METHODS: In total, 63 patients underwent total joint arthroplasty, with 45 PJI and 18 aseptic failure patients included. Joint fluids were sampled after antibiotics were withheld for more than 2 weeks, and then, culture, BR-PCR and mNGS were performed for all samples. RESULTS: The joint fluid BR-PCR sensitivity was 82.2%, which was not significantly different from that of mNGS (95.6%) or culture (77.8%). The specificities of the 3 methods were all 94.4%. BR-PCR failed to identify the pathogens in 1 polymicrobial infection patient and 4 fungal infection patients. CONCLUSION: mNGS was more sensitive than BR-PCR for detecting PJI pathogens in joint fluid. BR-PCR is insufficient for use as an mNGS verification method.
PURPOSE: The aims of our study were to (1) evaluate the concordance of both methods for detecting prosthetic joint infection (PJI) pathogens in joint fluid and to (2) clarify whether broad-range polymerase chain reaction (BR-PCR) can be used as a verification method for metagenomic next-generation sequencing (mNGS) for PJI diagnosis. METHODS: In total, 63 patients underwent total joint arthroplasty, with 45 PJI and 18 aseptic failurepatients included. Joint fluids were sampled after antibiotics were withheld for more than 2 weeks, and then, culture, BR-PCR and mNGS were performed for all samples. RESULTS: The joint fluid BR-PCR sensitivity was 82.2%, which was not significantly different from that of mNGS (95.6%) or culture (77.8%). The specificities of the 3 methods were all 94.4%. BR-PCR failed to identify the pathogens in 1 polymicrobial infectionpatient and 4 fungal infectionpatients. CONCLUSION: mNGS was more sensitive than BR-PCR for detecting PJI pathogens in joint fluid. BR-PCR is insufficient for use as an mNGS verification method.
Authors: Jun Tan; Yang Liu; Sabrina Ehnert; Andreas K Nüssler; Yang Yu; Jianzhong Xu; Tao Chen Journal: Front Cell Infect Microbiol Date: 2022-06-10 Impact factor: 6.073