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Direct detection and identification of periprosthetic joint infection pathogens by metagenomic next-generation

Linjie Hao1,2, Pengfei Wen2, Wei Song2

  • 1Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, Shaanxi, China.

Scientific Reports
|May 16, 2023
PubMed

Insights

Metagenomic next-generation sequencing (mNGS) significantly improves pathogen detection for periprosthetic joint infections compared to traditional culture methods. This advanced technique offers higher sensitivity and faster results, especially for challenging cases.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Genomics

Background:

  • Periprosthetic joint infection (PJI) is a serious complication after total joint replacement.
  • Accurate and timely pathogen identification is crucial for effective treatment.

Purpose of the Study:

  • To evaluate the diagnostic performance of metagenomic next-generation sequencing (mNGS) for PJI.
  • To compare mNGS with conventional culture methods in terms of sensitivity, specificity, and turnaround time.

Main Methods:

  • Retrospective analysis of 95 patients undergoing revision hip or knee replacement.
  • Collection of synovial fluid and deep-tissue specimens for both culture and mNGS.
  • Classification of patients as infected or aseptic using Musculoskeletal Infection Society criteria.

Main Results:

  • mNGS detected pathogens in 94.8% of infected cases, significantly higher than culture (58.6%).
  • mNGS identified pathogens in 87.5% of culture-negative PJI cases.
  • Average reporting time for mNGS (1.3 days) was substantially shorter than for culture (5.2 days).

Conclusions:

  • mNGS demonstrates superior sensitivity and speed for PJI pathogen detection.
  • mNGS is particularly valuable for diagnosing PJIs with negative cultures or polymicrobial infections.
  • This advanced sequencing technology enhances diagnostic accuracy and treatment planning for PJI.

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