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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Clinical Microbiology
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1457639
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 34 articles

Shedding Light on Negative Cultures in Osteoarticular Infections: Leveraging mNGS to Unravel Risk Factors and Microbial Profiles

Provisionally accepted
Haiqi Ding Haiqi Ding Jiexin Huang Jiexin Huang Lan Lin Lan Lin Yang Chen Yang Chen Qijin Wang Qijin Wang Wenbo Li Wenbo Li Ying Huang Ying Huang Xinyu Fang Xinyu Fang *Wenming Zhang Wenming Zhang *
  • First Affiliated Hospital of Fujian Medical University, Fuzhou, China

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

    Abstract: Background: The objective of this study is to utilize metagenomic next-generation se-quencing (mNGS) to analyze the risk factors causing negative microbial cultures, comprehen-sively delineate the microbial profiles neglected by traditional cultures, and optimize the patho-genetic diagnostic procedure accordingly. Research design and methods: We enrolled 341 pa-tients diagnosed with OI at our center between 2016 and 2022, and gathered data including age, gender, clinical diagnosis, duration of antibiotic use prior to sampling, microbial culture results, and mNGS results for these patients. According to microbial detection results, risk factors for negative microbial culture and mNGS results were investigated through univariate and multi-variate analyses, and the microbial profile in cases with negative microbial cultures was summa-rized in conjunction with mNGS results. Building upon this, we suggest strategies to enhance the positivity rate of microbial cultures based on clinical experience. Results: Invasive osteoar-ticular infection (IOI), multi-infections, rare pathogen infections, and prior antibiotic use are risk factors for negative microbial cultures. When the duration of prior antibiotic use is ≥3 days, mNGS demonstrates significantly higher pathogen detection efficiency than microbial culture. Moreover, the risk of negative microbial culture increases by 4.8 times with the exposure to each additional risk factor (OR=4.043, 95%CI [2.835, 5.765], P＜0.001). Additionally, over one-third of culture-negative OI involve polymicrobial infections or rare pathogens. Conclusions: Clinicians should tailor microbial culture strategies based on patient conditions. When needed, they can collaborate with mNGS or optimize microbial culture conditions based on mNGS results to en-hance the efficiency of pathogen diagnosis.

    Keywords: Osteoarticular infection, negative microbiological cultures, metagenomic next-generation sequencing, Risk factors, Pathogen diagnosis

    Received: 01 Jul 2024; Accepted: 04 Nov 2024.

    Copyright: © 2024 Ding, Huang, Lin, Chen, Wang, Li, Huang, Fang and Zhang. 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:
    Xinyu Fang, First Affiliated Hospital of Fujian Medical University, Fuzhou, China
    Wenming Zhang, First Affiliated Hospital of Fujian Medical University, Fuzhou, 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.