Detecting the presence of bacteria in low-volume preoperative aspirated synovial fluid by metagenomic next-generation sequencing
Detecting the presence of bacteria in low-volume preoperative aspirated synovial fluid by metagenomic next-generation sequencing
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通过宏基因组下一代测序检测术前少量抽吸滑液中细菌的存在
DOI：
10.1016/j.ijid.2020.07.039
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发表时间：
2020-10-01
影响因子：
8.4
通讯作者：
Guan, Zhenpeng
中科院分区：
文献类型：
--
作者：
Fang, Xinyu;Cai, Yuanqing;Guan, Zhenpeng
目的：术前诊断对于因PJI需要翻修手术的患者非常重要。微生物培养在PJI诊断中发挥着重要作用，但当样本量有限或患者在样本采集前接受抗生素治疗时，培养的敏感性较低。本研究采用宏基因组下一代测序技术（mNGS）对疑似PJI患者术前穿刺滑液标本进行细菌检测，并将术前和术中培养结果进行比较，以评估其诊断效率。方法：从2016年7月至2018年12月，纳入了接受人工关节翻修手术的疑似PJI患者，对术前行关节液培养和mNGS检测者进行结果分析。记录每例患者的人口统计学特征、病史、实验室检查结果、培养结果和mNGS结果。结果：共纳入37例患者，24例患者（25个关节）诊断为PJI。术前滑液mNGS的敏感性、特异性和准确性分别为92%、91.7%和83.7%。术前滑液培养的敏感性、特异性和准确性分别为52%、91.7%和43.7%，respectives.Conclusions：与滑液培养相比，低量滑液（1ml）的mNGS具有更高的敏感性和特异性。因此，mNGS可以是一个有用的补充方法，以提高诊断效率在术前阶段。(c)2020作者（S）由爱思唯尔有限公司代表国际传染病学会出版。
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. (c) 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.