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329. Performance of Next Generation Sequencing in Isolating a Pathogen in Pediatric Osteoarticular Infections

BACKGROUND: Osteoarticular infections are often encountered in the pediatric population. Therapy is guided by isolation of a putative organism, however, operative cultures are often negative. Next generation sequencing (NGS) allows for more sensitive sampling of body compartments generally considere...

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Autores principales: Ramchandar, Nanda, Burns, Jessica, Pennock, Andrew, Cannavino, Christopher R, Farnaes, Lauge
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776422/
http://dx.doi.org/10.1093/ofid/ofaa439.525
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author Ramchandar, Nanda
Burns, Jessica
Pennock, Andrew
Cannavino, Christopher R
Farnaes, Lauge
author_facet Ramchandar, Nanda
Burns, Jessica
Pennock, Andrew
Cannavino, Christopher R
Farnaes, Lauge
author_sort Ramchandar, Nanda
collection PubMed
description BACKGROUND: Osteoarticular infections are often encountered in the pediatric population. Therapy is guided by isolation of a putative organism, however, operative cultures are often negative. Next generation sequencing (NGS) allows for more sensitive sampling of body compartments generally considered sterile. We sought to evaluate the utility of NGS in comparison to culture in detecting a pathogenic organism in acute osteomyelitis and septic arthritis in children. METHODS: This was a single-site study to evaluate the utility of NGS in comparison to culture in detecting a pathogenic organism in acute osteomyelitis and septic arthritis in children. Eligible patients were all patients with osteomyelitis or septic arthritis admitted to Rady Children’s Hospital from July 2019 through July 2020. We excluded any patients with bone or joint surgery within 30 days prior to admission. Operative samples were chosen at the surgeon’s discretion (joint aspirate, synovium, or bone) based on operative findings. We compared NGS testing to standard care culture from the same site. RESULTS: We enrolled 41 subjects. NGS of the operative samples identified a pathogen in 26 (63.4%) patients versus 18 (43.9%) by culture. Operative culture missed the diagnosis in 10 cases, though PCR identified the organism in 6 of those cases (5 were cases in which Kingella kingae was identified). In 4 subjects, NGS identified a putative organism where standard care testing (either PCR or culture) was negative. NGS was falsely positive in 1 subject and falsely negative for one other subject. Sensitivity was 96.3% (CI 95%, 81.0–99.9%) and Specificity was 92.9% (CI 95%, 66.1–99.8) for NGS versus 64.3% (CI 95%, 44.1–81.4) and 84.6% (CI 95%, 54.6–99.9%) for culture respectively. CONCLUSION: In this single site prospective study of pediatric osteoarticular infections, we demonstrate improved sensitivity and specificity of NGS testing when compared to standard culture. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-77764222021-01-07 329. Performance of Next Generation Sequencing in Isolating a Pathogen in Pediatric Osteoarticular Infections Ramchandar, Nanda Burns, Jessica Pennock, Andrew Cannavino, Christopher R Farnaes, Lauge Open Forum Infect Dis Poster Abstracts BACKGROUND: Osteoarticular infections are often encountered in the pediatric population. Therapy is guided by isolation of a putative organism, however, operative cultures are often negative. Next generation sequencing (NGS) allows for more sensitive sampling of body compartments generally considered sterile. We sought to evaluate the utility of NGS in comparison to culture in detecting a pathogenic organism in acute osteomyelitis and septic arthritis in children. METHODS: This was a single-site study to evaluate the utility of NGS in comparison to culture in detecting a pathogenic organism in acute osteomyelitis and septic arthritis in children. Eligible patients were all patients with osteomyelitis or septic arthritis admitted to Rady Children’s Hospital from July 2019 through July 2020. We excluded any patients with bone or joint surgery within 30 days prior to admission. Operative samples were chosen at the surgeon’s discretion (joint aspirate, synovium, or bone) based on operative findings. We compared NGS testing to standard care culture from the same site. RESULTS: We enrolled 41 subjects. NGS of the operative samples identified a pathogen in 26 (63.4%) patients versus 18 (43.9%) by culture. Operative culture missed the diagnosis in 10 cases, though PCR identified the organism in 6 of those cases (5 were cases in which Kingella kingae was identified). In 4 subjects, NGS identified a putative organism where standard care testing (either PCR or culture) was negative. NGS was falsely positive in 1 subject and falsely negative for one other subject. Sensitivity was 96.3% (CI 95%, 81.0–99.9%) and Specificity was 92.9% (CI 95%, 66.1–99.8) for NGS versus 64.3% (CI 95%, 44.1–81.4) and 84.6% (CI 95%, 54.6–99.9%) for culture respectively. CONCLUSION: In this single site prospective study of pediatric osteoarticular infections, we demonstrate improved sensitivity and specificity of NGS testing when compared to standard culture. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7776422/ http://dx.doi.org/10.1093/ofid/ofaa439.525 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Abstracts
Ramchandar, Nanda
Burns, Jessica
Pennock, Andrew
Cannavino, Christopher R
Farnaes, Lauge
329. Performance of Next Generation Sequencing in Isolating a Pathogen in Pediatric Osteoarticular Infections
title 329. Performance of Next Generation Sequencing in Isolating a Pathogen in Pediatric Osteoarticular Infections
title_full 329. Performance of Next Generation Sequencing in Isolating a Pathogen in Pediatric Osteoarticular Infections
title_fullStr 329. Performance of Next Generation Sequencing in Isolating a Pathogen in Pediatric Osteoarticular Infections
title_full_unstemmed 329. Performance of Next Generation Sequencing in Isolating a Pathogen in Pediatric Osteoarticular Infections
title_short 329. Performance of Next Generation Sequencing in Isolating a Pathogen in Pediatric Osteoarticular Infections
title_sort 329. performance of next generation sequencing in isolating a pathogen in pediatric osteoarticular infections
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776422/
http://dx.doi.org/10.1093/ofid/ofaa439.525
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