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The potential of metagenomic next-generation sequencing in diagnosis of spinal infection: a retrospective study

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Abstract

Purpose

Metagenomic next-generation sequencing (mNGS) is a new approach to identify the infecting organism in infectious diseases. Our aim was to evaluate the accuracy of mNGS in determining the etiology of spinal infection.

Methods

In this retrospective study, patients who had a suspected spinal infection and underwent mNGS for diagnosis in our hospital were eligible for inclusion. Samples for mNGS, culture, and histopathological tests were collected surgically or with a CT-guided needle biopsy. Sensitivity and specificity were calculated for mNGS and culture test, using histopathological results as reference.

Results

A total of 31 mNGS tests in 30 cases were included. Twenty-six cases were classified as infected, and four cases were considered aseptic. mNGS achieved a specificity of 75.0% [95% confidence interval (CI), 21.9% to 98.7%], sensitivity was 70.3% (95% CI, 49.7% to 85.5%). mNGS was more sensitive than culture at 14.8% (95% CI, 4.9% to 34.6%, P < 0.0001). However, the specificities of mNGS and culture were statistically similar.

Conclusion

We described here the power of mNGS in the etiological diagnosing of spinal infection. Our study opens the possibility for more extensive use of mNGS techniques in the identification of pathogens in patients with suspected spinal infection.

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Acknowledgements

Funding was provided by National Natural Science Foundation of China (Grant No. 82001458) and Medical Health Science and Technology Project of Zhejiang Provincial Health Commission (Grant No. 2018RC033).

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Authors and Affiliations

  1. Department of Orthopedics Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People’s Republic of China

    Chiyuan Ma, Haobo Wu, Gang Chen, Chengzhen Liang & Yuxiang Xiao

  2. Orthopedics Research Institute of Zhejiang University, Zhejiang Province, Hangzhou, People’s Republic of China

    Chiyuan Ma, Haobo Wu, Gang Chen, Chengzhen Liang & Yuxiang Xiao

  3. Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, Zhejiang Province, Hangzhou, People’s Republic of China

    Chiyuan Ma, Haobo Wu, Gang Chen, Chengzhen Liang & Yuxiang Xiao

  4. Department of Radiation Oncology, The 1st Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, People’s Republic of China

    Lingyun Wu

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  1. Chiyuan Ma
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  2. Haobo Wu
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  3. Gang Chen
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  4. Chengzhen Liang
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  5. Lingyun Wu
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Correspondence to Lingyun Wu or Yuxiang Xiao.

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Ma, C., Wu, H., Chen, G. et al. The potential of metagenomic next-generation sequencing in diagnosis of spinal infection: a retrospective study. Eur Spine J 31, 442–447 (2022). https://doi.org/10.1007/s00586-021-07026-5

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  • DOI: https://doi.org/10.1007/s00586-021-07026-5

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