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Characterization of periprosthetic environment microbiome in patients after total joint arthroplasty and its

Hao Li1,2, Jun Fu2, Niu Erlong3

  • 1Medical School of Chinese PLA, Beijing, People's Republic of China.

BMC Infectious Diseases
|June 22, 2023
PubMed
Abstract

Insights

This study characterizes the periprosthetic microbiome in patients undergoing total joint arthroplasty (TJA). A novel typing system identified four distinct microbiota types, aiding in periprosthetic joint infection (PJI) diagnosis.

Area of Science:

  • Microbiology
  • Orthopedic Surgery
  • Genomics

Background:

  • Periprosthetic joint infection (PJI) is a severe complication following total joint arthroplasty (TJA).
  • The microbiome of the periprosthetic environment after TJA has not been well-characterized.
  • Understanding this microbiome is crucial for diagnosing and managing PJI.

Purpose of the Study:

  • To explore the periprosthetic microbiota in patients with suspected PJI using metagenomic next-generation sequencing (mNGS).
  • To develop a classification system for the periprosthetic microbiota.
  • To correlate microbiota types with clinical PJI indicators.

Main Methods:

  • Prospective study involving 28 culture-positive PJI, 14 culture-negative PJI, and 35 non-PJI patients.
  • Joint aspiration followed by untargeted mNGS and bioinformatics analysis.
  • Development and external validation of a RandomForest-based microbiota 'typing system'.

Main Results:

  • The periprosthetic microbiome significantly differed between PJI and non-PJI groups.
  • Four general microbiota types were identified: 'Staphylococcus', 'Pseudomonas', 'Escherichia', and 'Cutibacterium'.
  • The 'Staphylococcus' and 'Pseudomonas' types were associated with higher inflammation and confirmed PJI, with Staphylococcus spp. correlating with inflammatory markers.

Conclusions:

  • This study provides the first characterization of the periprosthetic environment microbiome after TJA.
  • A basic microbiota 'typing system' was established using a RandomForest model.
  • This classification system can serve as a reference for future PJI research and diagnosis.
Keywords:
Metagenomic next generation sequencingMicrobiomeMicrobiotaPeriprosthetic joint infectionPolymicrobial infectionTotal joint arthroplasty

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