Direct detection and identification of periprosthetic joint infection pathogens by metagenomic next-generation sequencing

Hao, Linjie; Wen, Pengfei; Song, Wei; Zhang, Bin-Fei; Wu, Yanjie; Ma, Tao; Qiu, Yusheng

doi:10.1038/s41598-023-35215-3

Cited by 12 publications

(4 citation statements)

References 43 publications

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“…Compared with microbial culture, mNGS identified identical pathogens in 94.8% of culture-positive PJIs and detected potential pathogens in 43.9% of culture-negative PJIs. Similarly, several other studies reported that the positive detection rate of mNGS was 83.0-97.1% in culture-positive PJIs (Ivy et al, 2018;Hao et al, 2023) and 25-81.8% in samples with negative culture results (Ivy et al, 2018;Tarabichi et al, 2018), indicating that this method can be used as an alternative to culture. The proportion of total and partial in cases with concurrent positive culture and positive mNGS was 93.1% (81/87), which is an acceptable concordance rate.…”

Section: Discussionmentioning

confidence: 57%

“…Currently, diagnosis is still a challenge in the field of orthopaedics ( Kapadia et al., 2016 ; Triantafyllopoulos et al., 2016 ). With the rapid development of culture-independent molecular technologies over the last decade, there have been increasing reports on the use of mNGS for pathogen identification, demonstrating that mNGS is superior to traditional culture in the diagnosis of PJI ( He et al., 2021 ; Hao et al., 2023 ).…”

Section: Discussionmentioning

confidence: 99%

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Will previous antimicrobial therapy reduce the positivity rate of metagenomic next-generation sequencing in periprosthetic joint infections? A clinical study

Hao,

Bian,

Qing

et al. 2024

Front. Cell. Infect. Microbiol.

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BackgroundMetagenomic 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.MethodsWe 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.ResultsAmong 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.ConclusionmNGS 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.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Will previous antimicrobial therapy reduce the positivity rate of metagenomic next-generation sequencing in periprosthetic joint infections? A clinical study

Hao,

Bian,

Qing

et al. 2024

Front. Cell. Infect. Microbiol.

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“…However, two pathogens were confirmed using the MTP method in culture-negative samples; other pathogens were identified in culture-positive samples. Other studies showed metagenomic next-generation sequencing can identify a wide range of pathogens, although the presence of human and contaminant microbial DNA from reagents is challenging [ 22 , 23 ]. The utility of 16S rRNA gene-based targeted metagenomic sequencing was comparable to that of metagenomic next-generation sequencing [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Role of α-Defensin and the Microbiome in Prosthetic Joint Infection: A Prospective Cohort Study in Korea

Baek,

Lee,

Lee

et al. 2023

JCM

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The utility of α-defensin (AD), leukocyte esterase (LE) levels, and metagenomics sequencing as diagnostic tools for prosthetic joint infection (PJI) has been suggested, but there are few studies among the Asian population. This study aimed to evaluate the diagnostic performance of various biomarkers for PJI and the role of the microbiome in the synovial fluid of patients with prostheses. Patients with suspected knee PJI were enrolled, and their blood and synovial fluid were collected. The cases were classified into the PJI and non-PJI groups. Significant differences between the two groups were observed in the levels of AD (4698 µg/L vs. 296 µg/L, p < 0.001) and positivity for LE (62.5% vs. 21.1%, p = 0.01). AD had 94.4% sensitivity and 89.5% specificity for diagnosing PJI, whereas LE had 37.5% sensitivity and 100% specificity. Microbiome taxonomic profiling showed high sensitivity. The number of operational taxonomic units and the richness of the microbiome in the synovial fluid were higher in the non-PJI than in the PJI group. AD has shown encouraging results in the Asian population as a diagnostic biomarker for PJI, and LE can be used as a diagnostic adjunct. The bacterial richness of the synovial fluid is likely associated with infections.

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“…7,[10][11][12][13] To address these challenges, researchers have explored alternative diagnostic methods such as advanced imaging techniques, molecular assays, and biomarker profiling. 14,15 Moreover, investigations into the host immune response and identification of specific biomarkers associated with hip PJIs have gained attention as potential diagnostic tools. 16 Numerous studies have explored the role of microRNA (miRNA) regulation in the immune response against bacterial pathogens.…”

Section: Introductionmentioning

confidence: 99%

MicroRNA expression analysis in peripheral blood and soft-tissue of patients with periprosthetic hip infection

Paksoy,

Meller,

Schwotzer

et al. 2024

Bone Jt Open

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AimsCurrent diagnostic tools are not always able to effectively identify periprosthetic joint infections (PJIs). Recent studies suggest that circulating microRNAs (miRNAs) undergo changes under pathological conditions such as infection. The aim of this study was to analyze miRNA expression in hip arthroplasty PJI patients.MethodsThis was a prospective pilot study, including 24 patients divided into three groups, with eight patients each undergoing revision of their hip arthroplasty due to aseptic reasons, and low- and high-grade PJI, respectively. The number of intraoperative samples and the incidence of positive cultures were recorded for each patient. Additionally, venous blood samples and periarticular tissue samples were collected from each patient to determine miRNA expressions between the groups. MiRNA screening was performed by small RNA-sequencing using the miRNA next generation sequencing (NGS) discovery (miND) pipeline.ResultsOverall, several miRNAs in plasma and tissue were identified to be progressively deregulated according to ongoing PJI. When comparing the plasma samples, patients with a high-grade infection showed significantly higher expression levels for hsa-miR-21-3p, hsa-miR-1290, and hsa-miR-4488, and lower expression levels for hsa-miR-130a-3p and hsa-miR-451a compared to the aseptic group. Furthermore, the high-grade group showed a significantly higher regulated expression level of hsa-miR-1260a and lower expression levels for hsa-miR-26a-5p, hsa-miR-26b-5p, hsa-miR-148b-5p, hsa-miR-301a-3p, hsa-miR-451a, and hsa-miR-454-3p compared to the low-grade group. No significant differences were found between the low-grade and aseptic groups. When comparing the tissue samples, the high-grade group showed significantly higher expression levels for 23 different miRNAs and lower expression levels for hsa-miR-2110 and hsa-miR-3200-3p compared to the aseptic group. No significant differences were found in miRNA expression between the high- and low-grade groups, as well as between the low-grade and aseptic groups.ConclusionWith this prospective pilot study, we were able to identify a circulating miRNA signature correlating with high-grade PJI compared to aseptic patients undergoing hip arthroplasty revision. Our data contribute to establishing miRNA signatures as potential novel diagnostic and prognostic biomarkers for PJI.Cite this article: Bone Jt Open 2024;5(6):479–488.

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Direct detection and identification of periprosthetic joint infection pathogens by metagenomic next-generation sequencing

Cited by 12 publications

References 43 publications

Will previous antimicrobial therapy reduce the positivity rate of metagenomic next-generation sequencing in periprosthetic joint infections? A clinical study

Will previous antimicrobial therapy reduce the positivity rate of metagenomic next-generation sequencing in periprosthetic joint infections? A clinical study

Role of α-Defensin and the Microbiome in Prosthetic Joint Infection: A Prospective Cohort Study in Korea

MicroRNA expression analysis in peripheral blood and soft-tissue of patients with periprosthetic hip infection

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