Value of metagenomic next-generation sequencing in the diagnosis of native pyogenic spinal infections: a multicenter, retrospective observational study
Zhaohui Li MD , Qiang Zhang MD , Xiaofeng Lian MD , Chuqiang Yin MD , Yuhan Lin , Yuelei Wang MD , Zengshuai Han MD , Feng Shen MD , Yidan Xu MD , Huafeng Wang MD , Ting Wang MD
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引用次数: 0
Abstract
BACKGROUND CONTEXT
The etiological diagnosis of pyogenic spinal infection is crucial for its precise antibiotic treatment. Traditional methods of detection are often slow and ineffective. In recent times, metagenomic next-generation sequencing (mNGS) has revolutionized pathogen detection, offering a more effective approach to disease management.
PURPOSE
Comparing mNGS with microbial culture to comprehensively explore the diagnostic value of mNGS in pyogenic spinal infections.
DESIGN
A multicenter, retrospective observational study.
PATIENT SAMPLE
In a multicenter retrospective observational study, we analyzed the data from 301 patients admitted in four selected hospitals with pyogenic spinal infections from December 2019 to February 2024.
OUTCOME MEASURES
Identification of pathogenic bacteria in patients.
METHODS
Obtain blood and lesion tissue or pus samples from the enrolled patients for microbial culture, serological and hematological laboratory tests, pathological examination, and mNGS analysis, followed by a comparative analysis of the results.
RESULTS
In our cohort of 301 cases of clinically diagnosed pyogenic spinal infections, 242 yielded etiological evidence. The most common gram-positive bacterium was Staphylococcus aureus, and the most common gram-negative bacterium was Escherichia coli. mNGS showed a significantly higher rate of detection (77.9%) compared with microbial culture (27.2%) with a notable difference (X² = 140.17, P<.001). In culture-negative samples, mNGS could detect pathogens in 73.1% of cases, and in culture-positive samples, it could detect pathogens in 91.5% of cases with 94.7% genus-level concordance. mNGS provided faster results (24–48 h) compared with the culture method (2–7 days).
CONCLUSIONS
mNGS serves as a valuable supplement to the culture method and shows potential in identifying the causative pathogen in native pyogenic spinal infections.
期刊介绍:
The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.