Evaluation of infections in orthopedic patients using next-generation sequencing
Evaluation of infections in orthopedic patients using next-generation sequencing
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DOI：
10.1016/j.jiac.2021.07.019
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发表时间：
2021-09-08
影响因子：
2.2
通讯作者：
Nagashima, Hideki
中科院分区：
文献类型：
--
作者：
Ogawa, Shinya;Chikumi, Hiroki;Nagashima, Hideki
前言：培养试验用于诊断感染，但在骨科病例中检测感染存在敏感性低等各种问题。为了解决这一问题，能够全面搜索细菌基因的下一代测序（NGS）分析正在临床应用。在这项研究中，我们研究了NGS分析是否有助于评估骨科病例的感染。方法：研究对象为2016年至2017年间疑似感染的23例患者。从疑似感染的组织中采集样本，进行培养试验和NGS分析，比较培养试验和NGS分析的阳性率。我们还试图确定NGS分析的截止值。结果：最终诊断为感染20例，非感染3例。培养试验的灵敏度为70%，NGS分析的灵敏度为55%。当将多样性指数设置为临界值进行NGS分析时，辛普森指数的敏感性为75%。在本研究中，使用NGS指数进行分析时，灵敏度为90%，NGS指数是多样性指数和OTUs （operational taxonomic units）值的组合。结论：与培养试验相比，采用NGS指数进行NGS分析具有良好的敏感性和特异性。因此，NGS分析是评估骨科病例感染的有用方法。
Introduction: Culture tests are used to diagnose infections, but there are various problems such as low sensitivity in detecting infections in orthopedic cases. To address this problem, next generation sequencing (NGS) analysis, which can comprehensively search for bacterial genes, is being applied clinically. In this study, we examined whether NGS analysis was useful in evaluating infections in orthopedic cases. Methods: The participants were 23 patients suspected of having an infection between 2016 and 2017. Samples were collected from tissues suspected of being infected and were subjected to culture tests and NGS analysis, and the positive rates from the culture tests and from the NGS analysis were compared. We also attempted to determine cutoff value for the NGS analysis. Results: A total of 20 cases were ultimately diagnosed as infections and 3 cases were diagnosed as non-infections. The sensitivity of the culture tests was 70%, and the sensitivity of the NGS analysis was 55%. When the NGS analysis was performed with the diversity index set to the cut-off value, the sensitivity was 75% for the Simpson index. In this study, the sensitivity was 90% when the analysis was performed using the NGS index, which is a combination of the diversity index and the OTUs (operational taxonomic units) value. Conclusion: NGS analysis using the NGS index showed excellent sensitivity and specificity compared to culture tests. NGS analysis is therefore a useful modality for assessing infections in orthopedic cases.