Comparison of broad-range polymerase chain reaction and metagenomic next-generation sequencing for the diagnosis of prosthetic joint infection. (June 2020)

• Record Type: Journal Article
• Authors: Wang, Chao-xin; Huang, Zida; Fang, Xinyu; Li, Wenbo; Yang, Bin; Zhang, Wenming
• Is Part Of: International journal of infectious diseases. Volume 95(2020)
• Page Start: 8
• Page End: 12
• Publication Date: 2020-06
• Subjects: Broad-range polymerase chain reaction -- Metagenomic next-generation sequencing -- Prosthetic joint infection -- Joint fluid; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2020.03.055
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: This study performed the BR-PCR and mNGS methods to analyze joint fluid samples of patients undergoing revision surgery. mNGS can provide rapid, accurate information on from the joint fluid, particularly in polymicrobial infections and fungal infections. BR-PCR cannot be used as a verification method for mNGS results due to the discordancy with the mNGS test results and the low positive rate of detection. Abstract: Purpose: The aims of our study were to (1) evaluate the concordance of both methods for detecting prosthetic joint infection (PJI) pathogens in joint fluid and to (2) clarify whether broad-range polymerase chain reaction (BR-PCR) can be used as a verification method for metagenomic next-generation sequencing (mNGS) for PJI diagnosis. Methods: In total, 63 patients underwent total joint arthroplasty, with 45 PJI and 18 aseptic failure patients included. Joint fluids were sampled after antibiotics were withheld for more than 2 weeks, and then, culture, BR-PCR and mNGS were performed for all samples. Results: The joint fluid BR-PCR sensitivity was 82.2%, which was not significantly different from that of mNGS (95.6%) or culture (77.8%). The specificities of the 3 methods were all 94.4%. BR-PCR failed to identify the pathogens in 1 polymicrobial infection patient and 4 fungal infection patients. Conclusion: mNGS was more sensitive than BR-PCR for detecting PJI pathogens in joint fluid. BR-PCR is insufficient for use as an mNGS verification method.