Detection of <i>Neisseria gonorrhoeae</i> from Joint Aspirate by Metagenomic Sequencing in Disseminated Gonococcal Infection

Asmerom, Betial; Drobish, Ian; Winckler, Britanny; Chiang, Leslie; Farnaes, Lauge; Beauchamp‐Walters, Julia; Bradley, John S.; Ramchandar, Nanda

doi:10.1093/jpids/piaa108

Cited by 6 publications

(4 citation statements)

References 11 publications

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“…mecA was not detected by the mNGS AMR pipeline in any other samples. In 4 subjects, mNGS identified a pathogen where usual care testing was negative (2 cases of Neisseria gonorrhoeae arthritis [ 18 ], 1 case of Brevundimonas vesicularis osteomyelitis, and 1 case of K kingae osteomyelitis). The 2 subjects with gonococcal infection were started on adequate empiric therapy based on clinical suspicion prior to return of the mNGS result.…”

Section: Resultsmentioning

confidence: 99%

Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections

Ramchandar

Burns

Coufal

et al. 2021

Open Forum Infectious Diseases

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Background Osteoarticular infections (OAI) are frequently encountered in children. Treatment may be guided by isolation of a pathogen; however, operative cultures are often negative. Metagenomic next-generation sequencing (mNGS) allows for broad and sensitive pathogen detection that is culture-independent. We sought to evaluate the diagnostic utility of mNGS in comparison to culture and usual care testing to detect pathogens in acute osteomyelitis and/or septic arthritis in children. Methods This was a single-site study to evaluate the use of mNGS in comparison to culture to detect pathogens in acute pediatric osteomyelitis and/or septic arthritis. Subjects admitted to a tertiary children’s hospital with suspected OAI were eligible for enrollment. We excluded subjects with bone or joint surgery within 30 days of admission or with chronic osteomyelitis. Operative samples were obtained at the surgeon’s discretion per standard care (fluid or tissue) and based on imagining and operative findings. We compared mNGS to culture and usual care testing (culture and PCR) from the same site. Results We recruited 42 subjects over the enrollment period. mNGS of the operative samples identified a pathogen in 26 subjects compared to 19 subjects in whom culture identified a pathogen. In four subjects, mNGS identified a pathogen where combined usual care testing (culture and PCR) was negative. Positive predictive agreement and negative predictive agreement both were 93.0% for mNGS. Conclusion In this single site prospective study of pediatric OAI, we demonstrated the diagnostic utility of mNGS testing in comparison to culture and usual care (culture and PCR) from operative specimens.

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Section: Resultsmentioning

confidence: 99%

Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections

Ramchandar

Burns

Coufal

et al. 2021

Open Forum Infectious Diseases

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“…Besides PCR, newer diagnostic testing such as metagenomic sequencing may be useful for the diagnosis of MTB complex OAIs, though data to support its use remain lacking. [19][20][21][22][23] Notably, 53.3% (8/15) of mycobacterial culture-positive children in this case series had M. bovis infection. This differs from previous large case series of MTB complex OAI in Europe that describe the incidence of M. bovis to be as low as 0.04%-0.08%.…”

Section: Discussionmentioning

confidence: 99%

“…Besides PCR, newer diagnostic testing such as metagenomic sequencing may be useful for the diagnosis of MTB complex OAIs, though data to support its use remain lacking. 19–23…”

Section: Discussionmentioning

confidence: 99%

Pediatric Osteoarticular Infections Caused by Mycobacteria Tuberculosis Complex: A 26-Year Review of Cases in San Diego, CA

Drobish

Ramchandar

Raabe

et al. 2021

Pediatric Infectious Disease Journal

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Background: Osteoarticular infections (OAIs) account for 10%-20% of extrapulmonary Mycobacteria tuberculosis (MTB) complex infections in children and 1%-2% of all pediatric tuberculosis infections. Treatment regimens and durations typically mirror recommendations for other types of extrapulmonary MTB, but there are significant variations in practice, with some experts suggesting a treatment course of 12 months or longer. Methods: We conducted a retrospective review of children diagnosed with MTB complex OAI and cared for between December 31, 1992, and December 31, 2018, at a tertiary care pediatric hospital near the United States-Mexico border. Results: We identified 21 children with MTB complex OAI during the study period. Concurrent pulmonary disease (9.5%), meningitis (9.5%), and intra-abdominal involvement (14.3%) were all observed. MTB complex was identified by culture from operative samples in 15/21 children (71.4%); 8/15 (53.3%) cultures were positive for Mycobacterium bovis. Open bone biopsy was the most common procedure for procurement of a tissue sample and had the highest culture yield. The median duration of antimicrobial therapy was 52 weeks (interquartile range, 46-58). Successful completion of therapy was documented in 15 children (71.4%). Nine children (42.9%) experienced long-term sequelae related to their infection. Conclusion: Among the 21 children with MTB complex OAI assessed, 8 of 15 (53.3%) children with a positive tissue culture had M. bovis, representing a higher percentage than in previous reports and potentially reflecting its presence in unpasteurized dairy products in the California-Baja region. Bone biopsy produced the highest culture yield in this study. Given the rarity of this disease, multicenter collaborative studies are needed to improve our understanding of the presentation and management of pediatric MTB complex OAI.

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“…Few studies have attempted to explore the cutoff values based on quantitative pathogen detection to differentiate patients and healthy controls. Even in the era of metagenomic next-generation sequencing, studies on the association of STI pathogens with syndrome are rare ( 12 ). Pathogen-specific syndromic testing for STIs is largely unavailable, despite the wide use of pathogen-based syndromic testing assays for other infectious diseases.…”

Section: Introductionmentioning

confidence: 99%

Qualitative and Quantitative Detection of Multiple Sexually Transmitted Infection Pathogens Reveals Distinct Associations with Cervicitis and Vaginitis

Kang

Liao

et al. 2022

Microbiol Spectr

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Detection of Neisseria gonorrhoeae from Joint Aspirate by Metagenomic Sequencing in Disseminated Gonococcal Infection

Cited by 6 publications

References 11 publications

Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections

Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections

Pediatric Osteoarticular Infections Caused by Mycobacteria Tuberculosis Complex: A 26-Year Review of Cases in San Diego, CA

Qualitative and Quantitative Detection of Multiple Sexually Transmitted Infection Pathogens Reveals Distinct Associations with Cervicitis and Vaginitis

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