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Can metagenomic next-generation sequencing identify the pathogens responsible for culture-negative prosthetic joint infection?

BACKGROUND: The aims of this study were to (1) evaluate the efficacy and safety of targeted antibiotics for the treatment of culture-negative prosthetic joint infection based on metagenomic next-generation sequencing results and (2) verify the accuracy and reliability of metagenomic next-generation...

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Autores principales: Wang, Chaoxin, Huang, Zida, Li, Wenbo, Fang, Xinyu, Zhang, Wenming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7106575/
https://www.ncbi.nlm.nih.gov/pubmed/32228597
http://dx.doi.org/10.1186/s12879-020-04955-2
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author Wang, Chaoxin
Huang, Zida
Li, Wenbo
Fang, Xinyu
Zhang, Wenming
author_facet Wang, Chaoxin
Huang, Zida
Li, Wenbo
Fang, Xinyu
Zhang, Wenming
author_sort Wang, Chaoxin
collection PubMed
description BACKGROUND: The aims of this study were to (1) evaluate the efficacy and safety of targeted antibiotics for the treatment of culture-negative prosthetic joint infection based on metagenomic next-generation sequencing results and (2) verify the accuracy and reliability of metagenomic next-generation sequencing for identifying pathogens related to culture-negative prosthetic joint infection. METHODS: Ninety-seven consecutive PJI patients, including 27 patients with culture-negative prosthetic joint infection, were treated surgically at our center. Thirteen of the 27 culture-negative prosthetic joint infection patients, who were admitted before June 2017 and treated with empirical antibiotics, comprised the empirical antibiotic group (EA group), and the other 14 patients, who were admitted after June 2017 and treated with targeted antibiotics according to their metagenomic next-generation sequencing results, were classified as the targeted antibiotic group (TA group). The short-term infection control rate, incidence of antibiotic-related complications and costs were compared between the two groups. RESULTS: Two of the patients in the EA group experienced debridement and prolonged antimicrobial therapy due to wound infection after the initial revision surgery. No recurrent infections were observed in the TA group; however, no significant difference in the infection control rate was found between the two groups (83.33% vs 100%, P = 0.217). More cases of antibiotic-related complications were recorded in the EA group (6 cases) than in the TA group (1 case), but the difference was not statistically significant (P = 0.0697). The cost of antibiotics obtained for the EA group was 20,168.37 Yuan (3236.38–45,297.16), which was higher than that found for the TA group (10,164.16 Yuan, 2959.54–16,661.04, P = 0.04). CONCLUSIONS: Targeted antibiotic treatment for culture-negative prosthetic joint infection based on metagenomic next-generation sequencing results is associated with a favorable outcome, and metagenomic next-generation sequencing is a reliable tool for identifying pathogens related to culture-negative prosthetic joint infection.
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spelling pubmed-71065752020-04-01 Can metagenomic next-generation sequencing identify the pathogens responsible for culture-negative prosthetic joint infection? Wang, Chaoxin Huang, Zida Li, Wenbo Fang, Xinyu Zhang, Wenming BMC Infect Dis Research Article BACKGROUND: The aims of this study were to (1) evaluate the efficacy and safety of targeted antibiotics for the treatment of culture-negative prosthetic joint infection based on metagenomic next-generation sequencing results and (2) verify the accuracy and reliability of metagenomic next-generation sequencing for identifying pathogens related to culture-negative prosthetic joint infection. METHODS: Ninety-seven consecutive PJI patients, including 27 patients with culture-negative prosthetic joint infection, were treated surgically at our center. Thirteen of the 27 culture-negative prosthetic joint infection patients, who were admitted before June 2017 and treated with empirical antibiotics, comprised the empirical antibiotic group (EA group), and the other 14 patients, who were admitted after June 2017 and treated with targeted antibiotics according to their metagenomic next-generation sequencing results, were classified as the targeted antibiotic group (TA group). The short-term infection control rate, incidence of antibiotic-related complications and costs were compared between the two groups. RESULTS: Two of the patients in the EA group experienced debridement and prolonged antimicrobial therapy due to wound infection after the initial revision surgery. No recurrent infections were observed in the TA group; however, no significant difference in the infection control rate was found between the two groups (83.33% vs 100%, P = 0.217). More cases of antibiotic-related complications were recorded in the EA group (6 cases) than in the TA group (1 case), but the difference was not statistically significant (P = 0.0697). The cost of antibiotics obtained for the EA group was 20,168.37 Yuan (3236.38–45,297.16), which was higher than that found for the TA group (10,164.16 Yuan, 2959.54–16,661.04, P = 0.04). CONCLUSIONS: Targeted antibiotic treatment for culture-negative prosthetic joint infection based on metagenomic next-generation sequencing results is associated with a favorable outcome, and metagenomic next-generation sequencing is a reliable tool for identifying pathogens related to culture-negative prosthetic joint infection. BioMed Central 2020-03-30 /pmc/articles/PMC7106575/ /pubmed/32228597 http://dx.doi.org/10.1186/s12879-020-04955-2 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Wang, Chaoxin
Huang, Zida
Li, Wenbo
Fang, Xinyu
Zhang, Wenming
Can metagenomic next-generation sequencing identify the pathogens responsible for culture-negative prosthetic joint infection?
title Can metagenomic next-generation sequencing identify the pathogens responsible for culture-negative prosthetic joint infection?
title_full Can metagenomic next-generation sequencing identify the pathogens responsible for culture-negative prosthetic joint infection?
title_fullStr Can metagenomic next-generation sequencing identify the pathogens responsible for culture-negative prosthetic joint infection?
title_full_unstemmed Can metagenomic next-generation sequencing identify the pathogens responsible for culture-negative prosthetic joint infection?
title_short Can metagenomic next-generation sequencing identify the pathogens responsible for culture-negative prosthetic joint infection?
title_sort can metagenomic next-generation sequencing identify the pathogens responsible for culture-negative prosthetic joint infection?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7106575/
https://www.ncbi.nlm.nih.gov/pubmed/32228597
http://dx.doi.org/10.1186/s12879-020-04955-2
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