Xinyu Fang1, Yuanqing Cai2, Tengbin Shi3, Zida Huang4, Chongjing Zhang5, Wenbo Li6, Chaofan Zhang7, Bin Yang8, Wenming Zhang9, Zhenpeng Guan10. 1. Department of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. Electronic address: fangxinyu001@qq.com. 2. Department of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. Electronic address: yuanqing_cai@yeah.net. 3. Department of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. Electronic address: 494809488@qq.com. 4. Department of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. Electronic address: huangzida@163.com. 5. Department of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. Electronic address: chongjingzhang@qq.com. 6. Department of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. Electronic address: liwenbo350001@163.com. 7. Department of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. Electronic address: drcfzhang@gmail.com. 8. Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. Electronic address: yangbin2864@163.com. 9. Department of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. Electronic address: zhangwm0591@fjmu.edu.cn. 10. Department of Orthopedic Surgery, Peking University Shougang Hospital, Beijing, China. Electronic address: 2050815894@qq.com.
Abstract
OBJECTIVES: Preoperative diagnosis is important for patients who need revision surgery due to PJI. Microbial culture plays an important role in PJI diagnosis, but the sensitivity of cultures is low when the sample amount is limited or when a patient is treated with antibiotics before sample collection. In this study, metagenomic next-generation sequencing (mNGS) was used to detect bacteria in preoperative puncture synovial fluid samples from patients with suspected PJI, and the preoperative and intraoperative culture results were compared to estimate its diagnostic efficiency. METHODS: From July 2016 to December 2018, patients with suspected PJI who underwent prosthetic joint revision surgery were included, and the results of those who had been tested by preoperative synovial fluid culture and mNGS were obtained. The demographic characteristics, medical history, laboratory test results, culture results, and mNGS results of each patient were recorded. Then, the efficiency of preoperative synovial fluid mNGS was compared to that of synovial fluid culture for diagnosing PJI. RESULTS: A total of 37 patients were included, and 24 patients (25 joints) were diagnosed with PJI. The sensitivity, specificity, and accuracy of preoperative synovial fluid mNGS were 92%, 91.7%, and 83.7%, respectively. The sensitivity, specificity, and accuracy of preoperative synovial fluid culture were 52%, 91.7%, and 43.7%, respectively. CONCLUSIONS: With a low volume of synovia (1 ml), mNGS can be performed with higher sensitivity and specificity compared to synovial culture. Thus, mNGS can be a useful supplemental method to improve diagnostic efficiency during the preoperative period.
OBJECTIVES: Preoperative diagnosis is important for patients who need revision surgery due to PJI. Microbial culture plays an important role in PJI diagnosis, but the sensitivity of cultures is low when the sample amount is limited or when a patient is treated with antibiotics before sample collection. In this study, metagenomic next-generation sequencing (mNGS) was used to detect bacteria in preoperative puncture synovial fluid samples from patients with suspected PJI, and the preoperative and intraoperative culture results were compared to estimate its diagnostic efficiency. METHODS: From July 2016 to December 2018, patients with suspected PJI who underwent prosthetic joint revision surgery were included, and the results of those who had been tested by preoperative synovial fluid culture and mNGS were obtained. The demographic characteristics, medical history, laboratory test results, culture results, and mNGS results of each patient were recorded. Then, the efficiency of preoperative synovial fluid mNGS was compared to that of synovial fluid culture for diagnosing PJI. RESULTS: A total of 37 patients were included, and 24 patients (25 joints) were diagnosed with PJI. The sensitivity, specificity, and accuracy of preoperative synovial fluid mNGS were 92%, 91.7%, and 83.7%, respectively. The sensitivity, specificity, and accuracy of preoperative synovial fluid culture were 52%, 91.7%, and 43.7%, respectively. CONCLUSIONS: With a low volume of synovia (1 ml), mNGS can be performed with higher sensitivity and specificity compared to synovial culture. Thus, mNGS can be a useful supplemental method to improve diagnostic efficiency during the preoperative period.
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