ArticleFrontiers in cellular and infection microbiology2022
Metagenomic next-generation sequencing assists the diagnosis treatment of fungal osteoarticular infections.
Article in Frontiers in cellular and infection microbiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- The heavy burden and treatment challenges of fungal periprosthetic joint infection: a systematic review of 489 joints.BMC musculoskeletal disorders · 2024Pooled it
- Spinal Tuberculosis Diagnosed by Metagenomics Capture (MetaCAP) in a Patient Undergoing Maintenance Hemodialysis: A Case Report.The American journal of case reports · 2026Article
- Species distribution, antifungal susceptibility, and clinical profiles of patients with osteoarticular fungal Infections: A retrospective study.New microbes and new infections · 2025Article
- A One- or Two-Stage Revision of Fungal Prosthetic Joint Infection: A Review of Current Knowledge, Pitfalls and Recommendations.Antibiotics (Basel, Switzerland) · 2025Review
- Diagnosis and surgical treatment of chronic destructive septic hip arthritis.Arthroplasty (London, England) · 2025Review
- Comprehensive analysis of culture-negative periprosthetic joint infection with metagenomic next-generation sequencing.Frontiers in cellular and infection microbiology · 2025Article
- Diagnosis and management of invasive fungal diseases by next-generation sequencing: are we there yet?Expert review of molecular diagnostics · 2024Review
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Fungal osteoarticular infection (FOI) is not commonly seen in clinical practice but proposes a great challenge to orthopedic surgeons. In this study, we aimed to investigate the risk factors, the clinical features, and surgical outcomes of FOI in our institution. Specifically, we aimed to explore the role of metagenomic next-generation sequencing (mNGS) in the diagnosis and treatment of FOI. Methods: All the patients who were diagnosed and managed with FOI in our institution from January 2007 to December 2020 were retrospectively reviewed, including primary fungal implant-related infection, primary fungal osteomyelitis or arthritis, and fungal infections secondary to bacterial osteomyelitis or implant-related bacterial infections. The potential risk factors and the clinical and surgical features were analyzed. The pathogen data were compared between culture and the mNGS test. Results: A total of 25 patients were included, namely, 12 primary implant-related infections, 7 primary fungal osteomyelitis or arthritis, and 6 fungal infections secondary to bacterial osteomyelitis or implant-related bacterial infections. Most cases had undergone multiple surgeries or long-term antibiotic treatment. Diagnosis was mainly based on microbial culture and the mNGS test. Optimization of culture methods and the use of mNGS assisted the diagnosis. Specifically, mNGS was performed in 12 patients, 5 of whom were culture-negative. In the remaining seven cases, mNGS demonstrated the same results as culture. Management of FOI was complicated as most patients required multiple surgeries followed by long-term antifungal treatment. In selected cases, antifungal-impregnated cement spacer retention can be an optional choice. The overall success rate was 100% (25/25) for our cohort. Conclusion: We concluded that patients with comorbidities and a history of multiple surgeries or long-term antibiotics are under higher risk for FOI. Use of mNGS assists the diagnosis and treatment of FOI. Surgery combined with long-term antifungal treatment achieved satisfactory outcomes. In selected cases, antifungal-impregnated cement spacer retention can be an optional treatment choice.
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