Journal
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
Volume 10, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fcimb.2020.00471
Keywords
metagenomic next-generation sequencing; osteoarticular infection; pathogen; diagnosis; culture
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Funding
- National Natural Science Foundation of China [81772251]
- Natural Science Foundation of Fujian Province [2019I10011, 2018Y4003]
- Fujian Medical University [2018QH1066]
- Joint Funds for the innovation of science and Technology, Fujian Province [2019Y9132]
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Objectives:To evaluate metagenomic next-generation sequencing (mNGS) as a diagnostic tool in detecting pathogens from osteoarticular infection (OAI) samples. Methods:130 samples of joint fluid, sonicate fluid, and tissue were prospectively collected from 92 patients with OAI. The performance of mNGS and microbiology culture was compared pairwise. Results:The overall sensitivity of mNGS was 88.5% (115/130), significantly higher than that of microbiological culture, which had a sensitivity of 69.2% (90/130,p< 0.01). Sensitivity was significantly higher for joint fluid (mNGS: 86.7% vs. microbiology culture: 68.7%,p< 0.01) and sonicate fluid (mNGS: 100% vs. microbiology culture: 66.7%,p< 0.05) samples. mNGS detected 12 pathogenic strains undetected by microbiological culture. Additional pathogens detected by mNGS wereCoagulase-negative Staphylococci, Gram-negative Bacillus, Streptococci, Anaerobe, non-tuberculosis mycobacterium, MTCP(p> 0.05), andMycoplasma(OR = infinity, 95% confidence interval, 5.12-infinity,p< 0.001). Additionally, sensitivity by mNGS was higher in antibiotic-treated samples compared to microbiological culture (89.7 vs. 61.5%,p< 0.01). Conclusions:mNGS is a robust diagnostic tool for pathogenic detection in samples from OAI patients, compared to routine cultures. The mNGS technique is particularly valuable to diagnose pathogens that are difficult to be cultured, or to test samples from patients previously treated with antibiotics.
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