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Abstract：
UNASSIGNED: The diagnosis of tubercular orthopedic implant-associated infection (TB-IAI) is challenging. This study evaluated the value of metagenomic next-generation sequencing (mNGS) for the diagnosis of TB-IAI and developed a standardized diagnostic procedure for TB-IAI.
UNASSIGNED: The records of all patients with TB-IAI diagnosed and treated at our institution between December 2018 and September 2022 were retrospectively reviewed. Patient demographic characteristics, medical history, laboratory test, microbial culture, histopathology, and mNGS results, and time to diagnosis were recorded. The diagnostic efficiency of mNGS for TB-IAI was assessed by comparing the results and diagnostic time with that of other diagnostic modalities.
UNASSIGNED: Ten patients were included in the analysis, including eight with prosthetic joint infections and two with fracture-related infections. The mNGS positivity rate was 100% (10/10), which was higher than that of TB-antibody (11%, 1/9), real-time quantitative polymerase chain reaction (22%, 2/9), T-SPOT.TB (25%, 2/8), purified protein derivative (50%, 4/8), microbial culture (50%, 5/10), and histopathology (20%, 2/10). mNGS shortened the time to diagnosis of TB-IAI. A standardized diagnostic procedure for TB-IAI was developed based on the findings.
UNASSIGNED: mNGS is useful for the diagnosis of TB-IAI. mNGS is recommended in cases where it is difficult to identify a pathogen using routine diagnostic tests. The standardized diagnostic procedure might improve TB-IAI diagnosis.
UNASSIGNED: TB-IAI is a rare infection, which occurs after orthopedic surgery and hard to diagnose microbiologically. mNGS is a new detection technique not yet discussed in current literature as a means for TB-IAI diagnostics. Here we describe a cohort of patients with TB-IAI diagnosed by mNGS show high efficiency of mNGS for detection of this pathology and present a clinical algorithm supplementing conventional methods for TB-IAI assessment.
UNASSIGNED: The records of all patients with TB-IAI diagnosed and treated at our institution between December 2018 and September 2022 were retrospectively reviewed. Patient demographic characteristics, medical history, laboratory test, microbial culture, histopathology, and mNGS results, and time to diagnosis were recorded. The diagnostic efficiency of mNGS for TB-IAI was assessed by comparing the results and diagnostic time with that of other diagnostic modalities.
UNASSIGNED: Ten patients were included in the analysis, including eight with prosthetic joint infections and two with fracture-related infections. The mNGS positivity rate was 100% (10/10), which was higher than that of TB-antibody (11%, 1/9), real-time quantitative polymerase chain reaction (22%, 2/9), T-SPOT.TB (25%, 2/8), purified protein derivative (50%, 4/8), microbial culture (50%, 5/10), and histopathology (20%, 2/10). mNGS shortened the time to diagnosis of TB-IAI. A standardized diagnostic procedure for TB-IAI was developed based on the findings.
UNASSIGNED: mNGS is useful for the diagnosis of TB-IAI. mNGS is recommended in cases where it is difficult to identify a pathogen using routine diagnostic tests. The standardized diagnostic procedure might improve TB-IAI diagnosis.
UNASSIGNED: TB-IAI is a rare infection, which occurs after orthopedic surgery and hard to diagnose microbiologically. mNGS is a new detection technique not yet discussed in current literature as a means for TB-IAI diagnostics. Here we describe a cohort of patients with TB-IAI diagnosed by mNGS show high efficiency of mNGS for detection of this pathology and present a clinical algorithm supplementing conventional methods for TB-IAI assessment.
摘要：
■结核性骨科植入物相关感染（TB-IAI）的诊断具有挑战性。这项研究评估了宏基因组下一代测序（mNGS）在TB-IAI诊断中的价值，并开发了TB-IAI的标准化诊断程序。
对2018年12月至2022年9月期间在我们机构诊断和治疗的所有TB-IAI患者的记录进行回顾性审查。患者人口学特征,病史,实验室测试,微生物培养,组织病理学,和mNGS结果，并记录诊断时间。通过将结果和诊断时间与其他诊断方式进行比较来评估mNGS对TB-IAI的诊断效率。
■10名患者被纳入分析，包括8例假肢关节感染和2例骨折相关感染。mNGS阳性率为100%(10/10)，高于TB抗体(11%，1/9),实时定量聚合酶链反应(22%，2/9),T-SPOT。TB（25%，2/8),纯化的蛋白质衍生物(50%，4/8),微生物培养(50%，5/10),和组织病理学(20%，2/10).mNGS缩短了TB-IAI的诊断时间。基于这些发现，开发了TB-IAI的标准化诊断程序。
■mNGS对TB-IAI的诊断很有用。在使用常规诊断测试难以鉴定病原体的情况下，建议使用mNGS。标准化诊断程序可能会改善TB-IAI诊断。
■TB-IAI是一种罕见的感染，这发生在整形外科手术后，很难在微生物学上诊断。mNGS是目前文献中尚未讨论的一种新的检测技术作为TB-IAI诊断手段。在这里，我们描述了由mNGS诊断的TB-IAI患者队列，显示出mNGS检测这种病理的高效率，并提出了一种补充常规TB-IAI评估方法的临床算法。
对2018年12月至2022年9月期间在我们机构诊断和治疗的所有TB-IAI患者的记录进行回顾性审查。患者人口学特征,病史,实验室测试,微生物培养,组织病理学,和mNGS结果，并记录诊断时间。通过将结果和诊断时间与其他诊断方式进行比较来评估mNGS对TB-IAI的诊断效率。
■10名患者被纳入分析，包括8例假肢关节感染和2例骨折相关感染。mNGS阳性率为100%(10/10)，高于TB抗体(11%，1/9),实时定量聚合酶链反应(22%，2/9),T-SPOT。TB（25%，2/8),纯化的蛋白质衍生物(50%，4/8),微生物培养(50%，5/10),和组织病理学(20%，2/10).mNGS缩短了TB-IAI的诊断时间。基于这些发现，开发了TB-IAI的标准化诊断程序。
■mNGS对TB-IAI的诊断很有用。在使用常规诊断测试难以鉴定病原体的情况下，建议使用mNGS。标准化诊断程序可能会改善TB-IAI诊断。
■TB-IAI是一种罕见的感染，这发生在整形外科手术后，很难在微生物学上诊断。mNGS是目前文献中尚未讨论的一种新的检测技术作为TB-IAI诊断手段。在这里，我们描述了由mNGS诊断的TB-IAI患者队列，显示出mNGS检测这种病理的高效率，并提出了一种补充常规TB-IAI评估方法的临床算法。
