Next-Generation Sequencing May Be Useful in Joint Infection
WEDNESDAY, Jan. 24, 2018 -- Next-generation sequencing may be useful for identifying causative organisms in culture-negative periprosthetic joint infection, according to a study published online Jan. 17 in The Journal of Bone & Joint Surgery.
Majd Tarabichi, M.D., from The Rothman Institute at Thomas Jefferson University in Philadelphia, and colleagues collected samples from 65 revision arthroplasties and 17 primary arthroplasties in a prospective study. At the time of surgery, synovial fluid, deep tissue, and swabs were obtained, and they were shipped to the laboratory for next-generation sequencing.
The researchers found that the cases were considered to be infected in 28 revisions; cultures and next-generation sequencing were positive in 17 and 25 cases (60.7 and 89.3 percent, respectively); in 15 cases there was concordance between culture and next-generation sequencing. Next-generation sequencing was able to identify an organism in nine of the 11 cases of culture-negative periprosthetic joint infection (81.8 percent). Microbes were identified by next-generation sequencing in nine of 36 aseptic revisions of negative cultures (25 percent) and in six of 17 primary total joint arthroplasties (35.3 percent). In most positive samples, next-generation sequencing detected several organisms; however, one or two organisms were dominant in the majority of patients who were infected.
"Further study is required to determine the clinical implications of isolated organisms in samples from patients who are not thought to be infected," the authors write.
One author disclosed financial ties to MicroGen Dx, the laboratories that were used for next-generation sequencing of the samples, as well as to the medical products industry.
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Posted: January 2018