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Detection value of third-generation sequencing to identify the pathogenic organisms in prosthetic joint infection

Wenteng Si1, Wenzhong Chen1, Bin Chen1

  • 1Zhengzhou Orthopaedic Hospital of Joint Surgery, Zhengzhou 450052, China.

Diagnostic Microbiology and Infectious Disease
|April 26, 2024
PubMed

Insights

Third-generation sequencing (TGS) offers superior detection of pathogens in prosthetic joint infections (PJI) compared to traditional microbial cultures. TGS provides faster, more sensitive results, aiding in quicker diagnosis and treatment of PJI.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Genomics

Background:

  • Prosthetic joint infection (PJI) is a significant complication following joint replacement surgery.
  • Accurate and timely diagnosis of PJI is crucial for effective treatment and patient outcomes.
  • Traditional microbial culture methods for PJI diagnosis have limitations in sensitivity and speed.

Purpose of the Study:

  • To compare the diagnostic performance of third-generation sequencing (TGS) against pathogenic microbial culture for detecting microorganisms in prosthetic joint infections (PJI).

Main Methods:

  • Arthrocentesis was performed on 29 patients undergoing hip and knee revision surgeries.
  • Samples were analyzed using both third-generation sequencing (TGS) and conventional pathogenic microbial culture.
  • Diagnostic values including sensitivity, specificity, and predictive values were calculated and compared.

Main Results:

  • TGS demonstrated significantly higher sensitivity (85.71%) compared to microbial culture (42.85%) in the PJI group.
  • TGS identified 17 different pathogenic microorganisms, including common and rare pathogens.
  • TGS provided faster results (23.8±3.6 h) than microbial culture (108.0±9.4 h), with comparable specificity and positive predictive value.

Conclusions:

  • Third-generation sequencing (TGS) shows higher sensitivity and speed for detecting pathogens in PJI compared to microbial culture.
  • TGS has potential for clinical application in the diagnosis of prosthetic joint infections.
  • Further studies are warranted to fully establish TGS in routine PJI diagnostics.
Keywords:
DiagnosisPathogenic microbiological cultureProsthetic joint infectionThird-generation sequencing

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