Pathogenic Detection by Metagenomic next-generation Sequencing in Spinal Infections

作者：Chuqiang Yin, Yanan Cong, Huafeng Wang, Dechun Wang, Xizhong Yang, Xuesong Wang, Ting Wang · 发表于：Spine · 年份：2024 · DOI：10.1097/brs.0000000000005148 · 被引用次数：15 · 研究领域：Infectious Diseases and Tuberculosis、Orthopedic Infections and Treatments、Genomics and Phylogenetic Studies

STUDY DESIGN: A retrospective, observational study. OBJECTIVE: To evaluate the ability and value of metagenomic next-generation sequencing (mNGS) in detecting pathogens from spinal infections. BACKGROUND: The pathogenic diagnosis of primary spinal infection is challenging. The widespread application of mNGs in clinical practice makes it particularly useful in detecting rare, emerging, and atypical complex infectious diseases. METHODS: From January 2019 to December 2023, 120 samples were retrospectively collected from patients suspected of spinal infections and undergoing treatment. Pairwise comparisons between traditional laboratory tests and mNGS were conducted for all cases. RESULTS: Among the 120 cases, 95 were diagnosed as spinal infections, while 25 were classified as noninfectious. Microbiological evidence was found in 59 cases, while 36 cases were clinically diagnosed as spinal infections without definitive microbiological evidence. Rare microorganisms such as Aspergillus fumigatus , Taifanglania major , and Coxiella burnetii were detected by mNGS. The positive rate of mNGS was significantly higher at 88.42% compared with microbiological culture (43.16%), P <0.001. At the genus level, mNGS exhibited a consistency rate of 86.44% (51/59) with confirmed microorganisms. MNGS demonstrated very good agreement with clinically confirmed microorganisms at the genus level (κ=0.833). The sensitivity, specificity, positive predictive value, and negative predictive value of mNGS we...