Evidence map›Paper›PMID 32864114›Full record

ArticleBone & joint research2020

Metagenomic next-generation sequencing of synovial fluid demonstrates high accuracy in prosthetic joint infection diagnostics: mNGS for diagnosing PJI.

Zida Huang, Wenbo Li, Gwo-Chin Lee, Xinyu Fang, Li Xing, Bin Yang, Jianhua Lin, Wenming Zhang

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Bone & joint research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 4 pooled it
10.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

65 citing papers in PubMed, 4 syntheses or guidelines pooled it, 100 citations in OpenAlex.

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5 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Zida HuangDepartment of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Wenbo LiDepartment of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Gwo-Chin LeeDepartment of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Xinyu FangDepartment of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Li XingBGI Genomics, BGI-Shenzhen, Shenzhen, China.
Bin YangDepartment of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Jianhua LinDepartment of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Wenming ZhangDepartment of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Fujian Medical University · CNFirst Affiliated Hospital of Fujian Medical University · CNBGI GenomicsUniversity of Pennsylvania · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe aim of this study was to evaluate the performance of metagenomic next-generation sequencing (mNGS) in detecting pathogens from synovial fluid of prosthetic joint infection (PJI) patients.

methodsA group of 75 patients who underwent revision knee or hip arthroplasties were enrolled prospectively. Ten patients with primary arthroplasties were included as negative controls. Synovial fluid was collected for mNGS analysis. Optimal thresholds were determined to distinguish pathogens from background microbes. Synovial fluid, tissue, and sonicate fluid were obtained for culture.

resultsA total of 49 PJI and 21 noninfection patients were finally included. Of the 39 culture-positive PJI cases, mNGS results were positive in 37 patients (94.9%), and were consistent with culture results at the genus level in 32 patients (86.5%) and at the species level in 27 patients (73.0%). Metagenomic next-generation sequencing additionally identified 15 pathogens from five culture-positive and all ten culture-negative PJI cases, and even one pathogen from one noninfection patient, while yielding no positive findings in any primary arthroplasty. However, seven pathogens identified by culture were missed by mNGS. The sensitivity of mNGS for diagnosing PJI was 95.9%, which was significantly higher than that of comprehensive culture (79.6%; p = 0.014). The specificity is similar between mNGS and comprehensive culture (95.2% and 95.2%, respectively; p = 1.0).

conclusionMetagenomic next-generation sequencing can effectively identify pathogens from synovial fluid of PJI patients, and demonstrates high accuracy in diagnosing PJI.Cite this article:

Indexed as

DiagnosisMetagenomic next-generation sequencingProsthetic joint infectionSynovial fluid

Identifiers

PMID32864114
PMCPMC7437524
OpenAlexW3046878830

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.