宏基因组二代测序在全膝关节置换术后假体周围感染诊断中的应用  

Application of metagenomic next generation sequencing in the diagnosis of periprosthetic infection after total knee arthroplasty

作　　者：宋燕华[1] 周子博 闫亚芳 郑岩[1] SONG Yan-hua;ZHOU Zi-bo;YAN Ya-fang;ZHENG Yan(Clinical Laboratory,Zhengzhou Orthopaedie Hospital,Henan 450052,China)

机构地区：[1]郑州市骨科医院检验科,河南450052

出　　处：《中国卫生检验杂志》2023年第16期1931-1933,1941,共4页Chinese Journal of Health Laboratory Technology

基　　金：河南省医学科技攻关计划联合共建项目(LHG J 20220895)。

摘　　要：目的探讨宏基因组二代测序(metagenomic next-generation sequencing,mNGS)技术在全膝关节置换术后假体周围感染(periprosthetic joint infection,PJI)病原菌检测中的应用价值。方法收集2020年5月—2022年9月在郑州市骨科医院行全膝关节置换术后疑似出现PJI的患者资料。对纳入患者同时进行细菌培养法和mNGS检测,并对结果进行比较分析。结果29例入选患者中,细菌培养法检测阳性14例(48.28%),共检出9种病原菌,mNGS检测阳性24例(82.76%),共检出17种病原菌,两者阳性率之间差异有统计学意义(P<0.05)。细菌培养法和mNGS有13例(44.83%)检测均为阳性,其中有10例结果完全一致,符合率为76.92%。4例(13.79%)检测均为阴性,11例(37.93%)仅mNGS检测阳性,1例(3.45%)仅细菌培养法检测阳性。细菌培养法所需平均时间为(4.24±3.17)d,mNGS所需平均时间为(1.75±0.64)d,两者之间差异有统计学意义(P<0.05)。结论mNGS能够快速准确地检测全膝关节置换术后PJI病原菌,对临床早期精准诊治具有重要意义。Objective This paper aims to investigate the application value of metagenomic next-generation sequencing(mNGS)in the detection of periprosthetic joint infection(PJI)pathogens after total knee arthroplasty(TKA).Methods The data of suspected PJI patients after total knee arthroplasty in Zhengzhou Orthopedic Hospital from May 2020 to September 2022 were collected.Bacterial culture and mNGS detection were performed in the included patients,and the results were compared and analyzed.Results Among the 29 enrolled patients,14 cases(48.28%)were positive by bacterial culture,and a total of 9 pathogens were detected,while 24 cases(82.76%)were positive by mNGS,and a total of 17 pathogens were detected.The difference in the positive rates between them was statistically significant(P<0.05).Thirteen cases(44.83%)of bacterial culture method and mNGS were positive,and 10 of them were completely consistent,the coincidence rate was 76.92%.Four cases(13.79%)were negative,11 cases(37.93%)were positive only by mNGS,and 1 case(3.45%)was positive only by bacterial culture.The average time required by bacterial culture was(4.24±3.17)d,and the average time required by mNGS was(1.75±0.64)d,and the difference was statistically significant(P<0.05).Conclusion mNGS can quickly and accurately detect PJI pathogens after total knee arthroplasty,which is of great significance for early clinical accurate diagnosis and treatment.

关 键 词：宏基因组二代测序 假体周围感染 细菌培养 诊断 

分 类 号：R446[医药卫生—诊断学]