Abstract：
To assess the value of next-generation sequencing (NGS) technology in the diagnosis of osteoarticular brucellosis pathogenesis. Fifty eight patients admitted to the Department of Orthopaedics, Hebei Provincial Chest Hospital from January 2021 to January 2023 were retrospectively analyzed, and the patients were classified into 48 cases in the osteoarticular brucellosis group and 10 cases in the nonosteoarticular brucellosis group according to the final clinical diagnosis. All patients underwent serum agglutination test (SAT), CT-guided puncture or surgical sampling of lesions for bacteriological culture and NGS after admission. The diagnostic efficacy of these three methods for osteoarticular brucellosis was compared using the final clinical diagnosis as the reference standard. Among the 58 patients with suspected osteoarticular brucellosis, 40 cases (68.97%) were positive by NGS, 33 cases (56.89%) by SAT and 10 cases (17.24%) by culture, and the differences were statistically significant (p < 0.05). Using the final clinical diagnosis as a criterion, the sensitivity of NGS, SAT, and culture for the detection of osteoarticular brucellosis was 83.33%, 62.50%, and 20.83%, respectively, the specificity was 100.00%, 70.00%, and 100.00%, the diagnostic accuracy was 86.20%, 63.79%, and 34.49%, and the κ values were 0.799, 0.590, and 0.504, respectively. NGS has a high pathogen detection rate and sensitivity in the pathogenetic diagnosis of patients with osteoarticular brucellosis and can provide clinical guidance for the diagnosis and management of patients with osteoarticular brucellosis.
摘要：
探讨下一代测序(NGS)技术在骨关节型布鲁氏菌病发病机制诊断中的应用价值。骨科收治的58名病人,方法回顾性分析河北省胸科医院2021年1月至2023年1月，根据最终的临床诊断，将患者分为骨关节型布鲁氏菌病组48例和非骨关节型布鲁氏菌病组10例。所有患者均接受血清凝集试验(SAT),入院后CT引导穿刺或手术取样进行细菌学培养和NGS。以最终临床诊断为参考标准,比较3种方法对骨关节型布鲁氏菌病的诊断效能。在58例疑似骨关节布鲁氏菌病的患者中，NGS阳性40例(68.97%),SAT33例（56.89%），文化10例（17.24%），差异均有统计学意义(p<0.05)。以最终的临床诊断为标准，NGS的灵敏度，SAT,骨关节型布鲁氏菌病的检出率为83.33%,62.50%,和20.83%，分别,特异性为100.00%，70.00%,和100.00%，诊断准确率为86.20%,63.79%,34.49%，κ值分别为0.799、0.590和0.504。NGS在骨关节型布鲁氏菌病患者的病原学诊断中具有较高的病原检出率和敏感性,可为骨关节型布鲁氏菌病患者的诊断和治疗提供临床指导。
