PDF(Pubmed)
Abstract：
Metagenomic next-generation sequencing (mNGS) is a culture-independent massively parallel DNA sequencing technology and it has been widely used for rapid etiological diagnosis with significantly high positivity rate. Currently, clinical studies on evaluating the influence of previous antimicrobial therapy on positivity rate of mNGS in PJIs are rarely reported. The present study aimed to investigate whether the positivity rate of mNGS is susceptible to previous antimicrobial therapy.
We performed a prospective trial among patients who undergone hip or knee surgery due to periprosthetic joint infection (PJI) to compare the positivity rate of culture and mNGS between cases with and without previous antimicrobial therapy, and the positivity rates between cases with different antimicrobial-free intervals were also analysed.
Among 131 included PJIs, 91 (69.5%) had positive cultures and 115 (87.8%) had positive mNGS results. There was no significant difference in the positivity rate of deep-tissue culture and synovial fluid mNGS between cases with and without previous antimicrobial therapy. The positivity rate of synovial fluid culture was higher in cases with previous antimicrobial therapy. The positivity rates of mNGS in synovial fluid decreased as the antimicrobial-free interval ranged from 4 to 14 days to 0 to 3 days.
mNGS is more advantageous than culture with a higher pathogen detection rate. However, our data suggested that antimicrobial agents may need to be discontinued more than 3 days before sampling to further increase the positivity rate of mNGS for PJIs.
We performed a prospective trial among patients who undergone hip or knee surgery due to periprosthetic joint infection (PJI) to compare the positivity rate of culture and mNGS between cases with and without previous antimicrobial therapy, and the positivity rates between cases with different antimicrobial-free intervals were also analysed.
Among 131 included PJIs, 91 (69.5%) had positive cultures and 115 (87.8%) had positive mNGS results. There was no significant difference in the positivity rate of deep-tissue culture and synovial fluid mNGS between cases with and without previous antimicrobial therapy. The positivity rate of synovial fluid culture was higher in cases with previous antimicrobial therapy. The positivity rates of mNGS in synovial fluid decreased as the antimicrobial-free interval ranged from 4 to 14 days to 0 to 3 days.
mNGS is more advantageous than culture with a higher pathogen detection rate. However, our data suggested that antimicrobial agents may need to be discontinued more than 3 days before sampling to further increase the positivity rate of mNGS for PJIs.
摘要：
■宏基因组下一代测序（mNGS）是一种独立于培养物的大规模平行DNA测序技术，已广泛用于快速病因诊断，具有显着的高阳性率。目前,关于评估既往抗菌治疗对PJIs中mNGS阳性率影响的临床研究很少报道.本研究旨在调查mNGS的阳性率是否对先前的抗菌治疗敏感。
我们在因关节假体周围感染（PJI）而接受髋关节或膝关节手术的患者中进行了一项前瞻性试验，以比较既往有和没有抗菌治疗的患者之间的培养和mNGS阳性率。并分析了不同无抗菌药物间隔的病例之间的阳性率。
■在131个包含的PJI中，91例（69.5%）培养阳性，115例（87.8%）mNGS阳性。在有和没有先前抗菌治疗的病例之间，深层组织培养和滑液mNGS的阳性率没有显着差异。在先前进行过抗菌治疗的情况下，滑液培养的阳性率更高。滑液中mNGS的阳性率随着无抗微生物剂间隔从4至14天到0至3天的范围而降低。
■mNGS比具有更高病原体检测率的培养更有利。然而,我们的数据提示,为了进一步提高mNGS对PJIs的阳性率,可能需要在采样前停用抗菌药物超过3天.
我们在因关节假体周围感染（PJI）而接受髋关节或膝关节手术的患者中进行了一项前瞻性试验，以比较既往有和没有抗菌治疗的患者之间的培养和mNGS阳性率。并分析了不同无抗菌药物间隔的病例之间的阳性率。
■在131个包含的PJI中，91例（69.5%）培养阳性，115例（87.8%）mNGS阳性。在有和没有先前抗菌治疗的病例之间，深层组织培养和滑液mNGS的阳性率没有显着差异。在先前进行过抗菌治疗的情况下，滑液培养的阳性率更高。滑液中mNGS的阳性率随着无抗微生物剂间隔从4至14天到0至3天的范围而降低。
■mNGS比具有更高病原体检测率的培养更有利。然而,我们的数据提示,为了进一步提高mNGS对PJIs的阳性率,可能需要在采样前停用抗菌药物超过3天.
