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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Clinical Microbiology
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1388765
This article is part of the Research Topic Application and Reliability Assessment of Next Generation Sequencing (NGS) and targeted NGS (tNGS) in the Diagnosis of Infectious Diseases-Volume III View all 28 articles

Metagenomic Next-Generation Sequencing Promotes Pathogen Detection Over Culture in Joint Infections with Previous Antibiotic Exposure

Provisionally accepted
Zongyan Gao Zongyan Gao 1Wendi Zheng Wendi Zheng 1Meng Zhang Meng Zhang 1Yanhua Gao Yanhua Gao 2Jincheng Huang Jincheng Huang 1Xiao Chen Xiao Chen 1Zhipeng Dai Zhipeng Dai 1Zhenyu Song Zhenyu Song 1Jiawei Feng Jiawei Feng 1Qianqian Cao Qianqian Cao 1Yi Jin Yi Jin 1*
  • 1 Department of Orthopedics, Henan Provincial People's Hospital, Zhengzhou, China
  • 2 Department of Anesthesia, The People's Hospital of Anyang City, Anyang, China

The final, formatted version of the article will be published soon.

    Objective: To investigate the diagnostic value of metagenomic next-generation sequencing (mNGS) in detecting pathogens from joint infection (JI) synovial fluid (SF) samples with previous antibiotic exposure. Methods: From January 2019 to January 2022, 59 cases with suspected JI were enrolled. All cases had antibiotic exposure within 2 weeks before sample collection. mNGS and conventional culture were performed on SF samples. JI was diagnosed based on history and clinical symptoms in conjunction with MSIS criteria. The diagnostic values, including sensitivity, specificity, positive/negative predictive values (PPV/NPV), and accuracy, were in comparison with mNGS and culture. Results: There were 47 of the 59 cases diagnosed with JI, while the remaining 12 were diagnosed with non-infectious diseases. The sensitivity of mNGS was 68.1%, which was significantly higher than that of culture (25.5%, p<0.01). The accuracy of mNGS was significantly higher at 71.2% compared to the culture at 39.0% (p <0.01). Eleven pathogenic strains were detected by mNGS but not by microbiological culture, which included Staphylococcus lugdunensis, Staphylococcus cohnii, Finegoldia magna, Enterococcus faecalis, Staphylococcus saprophytics, Escherichia coli, Salmonella enterica, Pseudomonas aeruginosa, Acinetobacter pittii Acinetobacter Pitter, Brucella ovis, and Coxiella burnetii Q fever Rickettsia. Antibiotic therapy was adjusted based on the mNGS results in 32 (68.1%) patients, including 12 (25.5%) and 20 (42.6%) patients, in whom treatment was upgraded and changed, respectively. All JI patients underwent surgery and received subsequent antibiotic therapy. They were followed up for an average of 23 months (20-27 months), and the success rate of treatment was 89.4%. Out of the 33 patients who had positive results for pathogens, reoperation was performed in 1 case (3.03%), while out of the 14 cases with negative results for both mNGS and cultures, reoperation was performed in 4 cases (28.6%).

    Keywords: metagenomic next-generation sequencing, Joint infection, antibiotics, culture, pathogen

    Received: 20 Feb 2024; Accepted: 08 Aug 2024.

    Copyright: © 2024 Gao, Zheng, Zhang, Gao, Huang, Chen, Dai, Song, Feng, Cao and Jin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yi Jin, Department of Orthopedics, Henan Provincial People's Hospital, Zhengzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.