AI Article Synopsis
- The study aimed to compare two methods for detecting pathogens in prosthetic joint infections (PJI) from joint fluid and evaluate the effectiveness of broad-range polymerase chain reaction (BR-PCR) as a backup for metagenomic next-generation sequencing (mNGS).
- A total of 63 patients undergoing total joint arthroplasty were analyzed, including 45 with PJI and 18 with aseptic failures, with samples collected after a waiting period off antibiotics.
- The results showed that mNGS had a higher sensitivity (95.6%) than BR-PCR (82.2%), indicating that mNGS is the more reliable method for detecting PJI pathogens, while BR-PCR is not suitable as a verification method for mNGS
Article Abstract
Purpose: The aims of our study were to (1) evaluate the concordance of both methods for detecting prosthetic joint infection (PJI) pathogens in joint fluid and to (2) clarify whether broad-range polymerase chain reaction (BR-PCR) can be used as a verification method for metagenomic next-generation sequencing (mNGS) for PJI diagnosis.
Methods: In total, 63 patients underwent total joint arthroplasty, with 45 PJI and 18 aseptic failure patients included. Joint fluids were sampled after antibiotics were withheld for more than 2 weeks, and then, culture, BR-PCR and mNGS were performed for all samples.
Results: The joint fluid BR-PCR sensitivity was 82.2%, which was not significantly different from that of mNGS (95.6%) or culture (77.8%). The specificities of the 3 methods were all 94.4%. BR-PCR failed to identify the pathogens in 1 polymicrobial infection patient and 4 fungal infection patients.
Conclusion: mNGS was more sensitive than BR-PCR for detecting PJI pathogens in joint fluid. BR-PCR is insufficient for use as an mNGS verification method.
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| http://dx.doi.org/10.1016/j.ijid.2020.03.055 | DOI Listing |
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