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Advancements in molecular biology have revolutionized the identification and characterization of bacteria, with multiple methods leveraging DNA sequencing for enhanced precision. As sequencing technologies improve and costs decline, these approaches are increasingly used in clinical, environmental, and evolutionary studies.Multilocus Sequence Typing (MLST) examines several housekeeping genes, essential chromosomal genes encoding cellular functions, to distinguish strains. Approximately...
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Characterizing the Native Microbiome Using Next-Generation Sequencing of Bilateral 'Aseptic' Knees.

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Next generation sequencing (NGS) identified microorganisms in some native knee joints with osteoarthritis. This finding is crucial for understanding the natural joint microbiome and improving prosthetic joint infection diagnosis.

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infectionmicrobiomenext generation sequencingosteoarthritistotal knee arthroplasty

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Area of Science:

  • Orthopedics
  • Microbiology
  • Genomics

Background:

  • Next-generation sequencing (NGS) can detect organisms missed by traditional methods in prosthetic joint infections.
  • Concerns exist that NGS may identify the natural joint microbiome instead of pathogens.
  • This study investigated microorganisms in native knee joints using NGS.

Purpose of the Study:

  • To evaluate the presence of microorganisms in native knee joints with osteoarthritis using NGS.
  • To determine if NGS can distinguish between the native joint microbiome and potential pathogens.
  • To inform the application of NGS in diagnosing prosthetic joint infections.

Main Methods:

  • Prospective enrollment of 40 patients undergoing total knee arthroplasty.
  • Collection of fluid and tissue samples from operative and nonoperative knees.
  • NGS analysis of samples and evaluation of patient characteristics for association with results.

Main Results:

  • 3.8% (3/80) of native knee samples showed positive NGS results.
  • Two positive samples contained multiple microorganisms; Cutibacterium acnes was most common.
  • No patient baseline characteristics were associated with positive NGS findings.

Conclusions:

  • Native knee joints with osteoarthritis can harbor microorganisms detectable by NGS.
  • Findings impact the understanding of the native joint microbiome.
  • Results have implications for the clinical use of NGS in suspected prosthetic joint infections.