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Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections
BACKGROUND: Osteoarticular infections (OAIs) are frequently encountered in children. Treatment may be guided by isolation of a pathogen; however, operative cultures are often negative. Metagenomic next-generation sequencing (mNGS) allows for broad and sensitive pathogen detection that is culture-ind...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8314938/ https://www.ncbi.nlm.nih.gov/pubmed/34322569 http://dx.doi.org/10.1093/ofid/ofab346 |
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author | Ramchandar, Nanda Burns, Jessica Coufal, Nicole G Pennock, Andrew Briggs, Benjamin Stinnett, Rita Bradley, John Arnold, John Liu, George Y Pring, Maya Upasani, Vidyadhar V Rickert, Kathleen Dimmock, David Chiu, Charles Farnaes, Lauge Cannavino, Christopher |
author_facet | Ramchandar, Nanda Burns, Jessica Coufal, Nicole G Pennock, Andrew Briggs, Benjamin Stinnett, Rita Bradley, John Arnold, John Liu, George Y Pring, Maya Upasani, Vidyadhar V Rickert, Kathleen Dimmock, David Chiu, Charles Farnaes, Lauge Cannavino, Christopher |
author_sort | Ramchandar, Nanda |
collection | PubMed |
description | BACKGROUND: Osteoarticular infections (OAIs) are frequently encountered in children. Treatment may be guided by isolation of a pathogen; however, operative cultures are often negative. Metagenomic next-generation sequencing (mNGS) allows for broad and sensitive pathogen detection that is culture-independent. We sought to evaluate the diagnostic utility of mNGS in comparison to culture and usual care testing to detect pathogens in acute osteomyelitis and/or septic arthritis in children. METHODS: This was a single-site study to evaluate the use of mNGS in comparison to culture to detect pathogens in acute pediatric osteomyelitis and/or septic arthritis. Subjects admitted to a tertiary children’s hospital with suspected OAI were eligible for enrollment. We excluded subjects with bone or joint surgery within 30 days of admission or with chronic osteomyelitis. Operative samples were obtained at the surgeon’s discretion per standard care (fluid or tissue) and based on imaging and operative findings. We compared mNGS to culture and usual care testing (culture and polymerase chain reaction [PCR]) from the same site. RESULTS: We recruited 42 subjects over the enrollment period. mNGS of the operative samples identified a pathogen in 26 subjects compared to 19 subjects in whom culture identified a pathogen. In 4 subjects, mNGS identified a pathogen where combined usual care testing (culture and PCR) was negative. Positive predictive agreement and negative predictive agreement both were 93.0% for mNGS. CONCLUSIONS: In this single-site prospective study of pediatric OAI, we demonstrated the diagnostic utility of mNGS testing in comparison to culture and usual care (culture and PCR) from operative specimens. |
format | Online Article Text |
id | pubmed-8314938 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-83149382021-07-27 Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections Ramchandar, Nanda Burns, Jessica Coufal, Nicole G Pennock, Andrew Briggs, Benjamin Stinnett, Rita Bradley, John Arnold, John Liu, George Y Pring, Maya Upasani, Vidyadhar V Rickert, Kathleen Dimmock, David Chiu, Charles Farnaes, Lauge Cannavino, Christopher Open Forum Infect Dis Major Article BACKGROUND: Osteoarticular infections (OAIs) are frequently encountered in children. Treatment may be guided by isolation of a pathogen; however, operative cultures are often negative. Metagenomic next-generation sequencing (mNGS) allows for broad and sensitive pathogen detection that is culture-independent. We sought to evaluate the diagnostic utility of mNGS in comparison to culture and usual care testing to detect pathogens in acute osteomyelitis and/or septic arthritis in children. METHODS: This was a single-site study to evaluate the use of mNGS in comparison to culture to detect pathogens in acute pediatric osteomyelitis and/or septic arthritis. Subjects admitted to a tertiary children’s hospital with suspected OAI were eligible for enrollment. We excluded subjects with bone or joint surgery within 30 days of admission or with chronic osteomyelitis. Operative samples were obtained at the surgeon’s discretion per standard care (fluid or tissue) and based on imaging and operative findings. We compared mNGS to culture and usual care testing (culture and polymerase chain reaction [PCR]) from the same site. RESULTS: We recruited 42 subjects over the enrollment period. mNGS of the operative samples identified a pathogen in 26 subjects compared to 19 subjects in whom culture identified a pathogen. In 4 subjects, mNGS identified a pathogen where combined usual care testing (culture and PCR) was negative. Positive predictive agreement and negative predictive agreement both were 93.0% for mNGS. CONCLUSIONS: In this single-site prospective study of pediatric OAI, we demonstrated the diagnostic utility of mNGS testing in comparison to culture and usual care (culture and PCR) from operative specimens. Oxford University Press 2021-07-17 /pmc/articles/PMC8314938/ /pubmed/34322569 http://dx.doi.org/10.1093/ofid/ofab346 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://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/ (https://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 | Major Article Ramchandar, Nanda Burns, Jessica Coufal, Nicole G Pennock, Andrew Briggs, Benjamin Stinnett, Rita Bradley, John Arnold, John Liu, George Y Pring, Maya Upasani, Vidyadhar V Rickert, Kathleen Dimmock, David Chiu, Charles Farnaes, Lauge Cannavino, Christopher Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections |
title | Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections |
title_full | Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections |
title_fullStr | Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections |
title_full_unstemmed | Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections |
title_short | Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections |
title_sort | use of metagenomic next-generation sequencing to identify pathogens in pediatric osteoarticular infections |
topic | Major Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8314938/ https://www.ncbi.nlm.nih.gov/pubmed/34322569 http://dx.doi.org/10.1093/ofid/ofab346 |
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