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[1]鄧?yán)?王少華,李征,等.Nano-seq宏基因組測序在關(guān)節(jié)置換術(shù)后假體周圍感染診斷中的應(yīng)用價值[J].中醫(yī)正骨,2023,35(10):7-11.
　DENG Lei,WANG Shaohua,LI Zheng,et al.Application value of Nano-seq metagenomic sequencing in diagnosis of periprosthetic infections after arthroplasty[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(10):7-11.
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Nano-seq宏基因組測序在關(guān)節(jié)置換術(shù)后假體周圍感染診斷中的應(yīng)用價值()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年10期
頁碼:
7-11
欄目:
臨床研究
出版日期:
2023-10-20

文章信息/Info

Title:
Application value of Nano-seq metagenomic sequencing in diagnosis of periprosthetic infections after arthroplasty
作者:
王少華2; 李征3; 楊光亞1; 于雅麗2; 侯穎周2; 李科偉2; 孫博2
1.河南中醫(yī)藥大學(xué)第一臨床醫(yī)學(xué)院,河南 鄭州 450046; 2.鄭州市骨科醫(yī)院,河南 鄭州 450052; 3.唐山市工人醫(yī)院,河北 唐山 063000
Author(s):
DENG Lei1; WANG Shaohua2; LI Zheng3; YANG Guangya1; YU Yali2; HOU Yingzhou2; LI Kewei2; SUN Bo2
1.The First Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China 2.Zhengzhou Orthopedics Hospital,Zhengzhou 450052,Henan,China 3.Tangshan Gongren Hospital,Tangshan 063000,Hebei,China
關(guān)鍵詞:
關(guān)節(jié)成形術(shù); 置換;  假體和植入物;  感染;  C-反應(yīng)蛋白質(zhì);  血沉;  纖維蛋白原;  微生物培養(yǎng)檢測;  Nano-seq宏基因組測序
Keywords:
arthroplasty; replacement;  prostheses and implants;  infection;  C-reactive protein;  blood sedimentation;  fibrinogen;  microorganism detection;  Nano-seq metagenomic sequencing
摘要:
目的:探討Nano-seq宏基因組測序在關(guān)節(jié)置換術(shù)后假體周圍感染診斷中的應(yīng)用價值。方法:納入38例人工關(guān)節(jié)置換術(shù)后因疑似假體周圍感染再次住院的患者。患者住院后,抽血測定血清C反應(yīng)蛋白(C-reactive protein,CRP)含量、血沉(erythrocyte sedimentation rate,ESR)和血漿纖維蛋白原(fibrinogen,FIB)含量等指標(biāo),抽取關(guān)節(jié)液進(jìn)行病原微生物培養(yǎng)和Nano-seq宏基因組測序。患者出院后,從病歷系統(tǒng)中提取患者住院時測定的血清CRP含量、ESR、血漿FIB含量及病原微生物培養(yǎng)檢驗(yàn)報告、Nano-seq宏基因組測序檢驗(yàn)報告及出院診斷結(jié)果。分別根據(jù)血清CRP含量、ESR、血漿FIB含量、病原微生物培養(yǎng)檢驗(yàn)報告、Nano-seq宏基因組測序檢驗(yàn)報告診斷假體周圍感染,并以出院診斷結(jié)果為金標(biāo)準(zhǔn),計(jì)算上述指標(biāo)診斷假體周圍感染的敏感度、特異度、準(zhǔn)確度、陽性預(yù)測值、陰性預(yù)測值。采用受試者操作特征(receiver operating characteristic,ROC)曲線評價不同指標(biāo)診斷假體周圍感染的應(yīng)用價值。結(jié)果:血清CRP含量診斷假體周圍感染的敏感度為90.48%、特異度為41.18%、準(zhǔn)確度為68.42%,ESR診斷假體周圍感染的敏感度為66.67%、特異度為64.71%、準(zhǔn)確度為65.79%,血漿FIB含量診斷假體周圍感染的敏感度為66.67%、特異度為70.59%、準(zhǔn)確度為68.42%,病原微生物培養(yǎng)診斷假體周圍感染的敏感度為61.90%、特異度為94.12%、準(zhǔn)確度為76.32%,Nano-seq宏基因組測序診斷假體周圍感染的敏感度為95.24%、特異度為82.35%、準(zhǔn)確度為89.47%。Nano-seq宏基因組測序診斷假體周圍感染的敏感度高于ESR、血漿FIB含量、病原微生物培養(yǎng)(P=0.045,P=0.045,P=0.020),特異度高于血清CRP含量(P=0.032),準(zhǔn)確度高于血清CRP含量、ESR、血漿FIB含量(P=0.047,P=0.026,P=0.047)。血清CRP含量、ESR、血漿FIB含量、病原微生物培養(yǎng)、Nano-seq宏基因組測序診斷假體周圍感染的ROC曲線下面積分別為0.791(P=0.002)、0.706(P=0.031)、0.734(P=0.014)、0.780(P=0.000)、0.888(P=0.000)。結(jié)論:Nano-seq宏基因組測序在關(guān)節(jié)置換術(shù)后假體周圍感染診斷中具有較高的應(yīng)用價值。
Abstract:
Objective:To explore the application value of Nano-seq metagenomic sequencing in the diagnosis of periprosthetic infections after arthroplasty.Methods:Thirty-eight patients re-hospitalized due to suspected periprosthetic infections after arthroplasty were included in the study.After the hospitalization,the blood and joint fluid samples were drawn from patients.The serum level of C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and the plasma level of fibrinogen(FIB)were measured,and the pathogenic microorganism detection and Nano-seq metagenomic sequencing were conducted.After hospital discharge,the information including serum level of CRP,ESR,plasma level of FIB,the pathogenic microorganism detection report,the Nano-seq metagenomic sequencing report and the discharge diagnosis was extracted from the electronic medical record system.Periprosthetic infections were diagnosed based on the serum level of CRP,ESR,plasma level of FIB,pathogenic microorganism detection report and Nano-seq metagenomic sequencing report respectively.With the hospital discharge diagnosis as the gold standard,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the above-mentioned indicators in diagnosing periprosthetic infections were calculated.The application value of different indicators in diagnosing periprosthetic infections was evaluated by using the receiver operating characteristic(ROC)curve.Results:The sensitivity,specificity and accuracy of serum CRP level in diagnosing periprosthetic infections were 90.48%,41.18% and 68.42% respectively.The sensitivity,specificity and accuracy of ESR were 66.67%,64.71% and 65.79% respectively.The sensitivity,specificity,and accuracy of plasma FIB level were 66.67%,70.59% and 68.42% respectively.The sensitivity,specificity and accuracy of pathogenic microorganism detection were 61.90%,94.12% and 76.32% respectively.The sensitivity,specificity and accuracy of Nano-seq metagenomic sequencing were 95.24%,82.35% and 89.47% respectively.The Nano-seq metagenomic sequencing had higher sensitivity than ESR,plasma FIB level and pathogenic microorganism detection(P=0.045,P=0.045,P=0.020),higher specificity than the serum CRP level(P=0.032),and higher accuracy than the serum CRP level,ESR and plasma FIB level(P=0.047,P=0.026,P=0.047)in diagnosing periprosthetic infections.The areas under the ROC curves of serum CRP level,ESR,plasma FIB level,pathogenic microorganism detection and Nano-seq metagenomic sequencing in diagnosing periprosthetic infections were 0.791(P=0.002),0.706(P=0.031),0.734(P=0.014),0.780(P=0.000)and 0.888(P=0.000)respectively.Conclusion:Nano-seq metagenomic sequencing demonstrates a high application value in the diagnosis of periprosthetic infections after arthroplasty.

參考文獻(xiàn)/References:

[1] MADRY H.Surgical therapy in osteoarthritis[J].Osteoarthritis Cartilage,2022,30(8):1019-1034.
[2] 蘆珊,唐虎子,朱賢友,等.關(guān)節(jié)置換術(shù)后手術(shù)部位及假體周圍感染與營養(yǎng)不良相關(guān)性的Meta分析[J].中華醫(yī)院感染學(xué)雜志,2021,31(5):685-690.
[3] AKINDOLIRE J,MORCOS M W,MARSH J D,et al.The economic impact of periprosthetic infection in total hip arthroplasty[J].Can J Surg,2020,63(1):E52-56.
[4] TAN J,LIU Y,EHNERT S,et al.The effectiveness of metagenomic next-generation sequencing in the diagnosis of prosthetic joint infection:a systematic review and meta-analysis[J].Front Cell Infect Microbiol,2022,12:875822.
[5] YIN H,XU D,WANG D.Diagnostic value of next-generation sequencing to detect periprosthetic joint infection[J].BMC Musculoskelet Disord,2021,22(1):252.
[6] ATHANASOPOULOU K,BOTI M A,ADAMOPOULOS P G,et al.Third-generation sequencing:the spearhead towards the radical transformation of modern genomics[J].Life(Basel),2021,12(1):30.
[7] HOANG M T V,IRINYI L,HU Y,et al.Long-reads-based metagenomics in clinical diagnosis with a special focus on fungal infections[J].Front Microbiol,2021,12:708550.
[8] YOUNG K T,LAHMERS K K,SELLERS H S,et al.Randomly primed,strand-switching,MinION-based sequencing for the detection and characterization of cultured RNA viruses[J].J Vet Diagn Invest,2021,33(2):202-215.
[9] 譚聃,歐銅.第三代測序技術(shù)的研究進(jìn)展與臨床應(yīng)用[J].生物工程學(xué)報,2022,38(9):3121-3130.
[10] PARVIZI J,TAN T L,GOSWAMI K,et al.The 2018 definition of periprosthetic hip and knee infection:an evidence-based and validated criteria[J].J Arthroplasty,2018,33(5):1309-1314.
[11] 黃金承,高宗炎,代志鵬,等.假體周圍感染診斷新檢驗(yàn)指標(biāo)的探討[J].中國矯形外科雜志,2021,29(16):1441-1445.
[12] 宏翊,鄧旺,李樺,等.關(guān)節(jié)液分析對診斷假體周圍感染價值的探討[J].中華骨與關(guān)節(jié)外科雜志,2021,14(2):112-115.
[13] PAZIUK T,RONDON A J,GOSWAMI K,et al.A novel adjunct indicator of periprosthetic joint infection:platelet count and mean platelet volume[J].J Arthroplasty,2020,35(3):836-839.
[14] LI C,RENZ N,TRAMPUZ A.Management of periprosthetic joint infection[J].Hip Pelvis,2018,30(3):138-146.
[15] SHI W,JIANG Y,WANG Y,et al.The diagnostic value of various inflammatory biomarkers for diagnosing periprosthe-tic joint infection is gender-specific[J].J Inflamm Res,2022,15:3975-3982.
[16] PAZ Z,ZHU C,LIEBER S B,et al.Presentation and outcomes of peri-prosthetic joint infection:a comparison of culture-positive and culture-negative disease[J].Surg Infect(Larchmt),2021,22(8):828-835.
[17] AKGUN D,MULLER M,PERKA C,et al.The serum level of C-reactive protein alone cannot be used for the diagnosis of prosthetic joint infections,especially in those caused by organisms of low virulence[J].Bone Joint J,2018,100-B(11):1482-1486.
[18] WATANABE S,KOBAYASHI N,TOMOYAMA A,et al.Clinical characteristics and risk factors for culture-negative periprosthetic joint infections[J].J Orthop Surg Res,2021,16(1):292.
[19] SIGMUND I K,PUCHNER S E,WINDHAGER R.Serum inflammatory biomarkers in the diagnosis of periprosthetic joint infections[J].Biomedicines,2021,9(9):1128.
[20] XIONG L,LI S,DAI M.Comparison of D-dimer with CRP and ESR for diagnosis of periprosthetic joint infection[J].J Orthop Surg Res,2019,14(1):240.
[21] GRZELECKI D,WALCZAK P,GRAJEK A,et al.Elevated plasma D-dimer concentration has higher efficacy for the diagnosis of periprosthetic joint infection of the knee than of the hip-a single-center,retrospective study[J].J Orthop Res,2021,39(2):291-298.
[22] BIN G,YANG X,FAN L,et al.Serum fibrinogen test performs well for the diagnosis of periprosthetic joint infection[J].J Arthroplasty,2020,35(9):2607-2612.
[23] YU X,JIANG W,SHI Y,et al.Applications of sequencing technology in clinical microbial infection[J].J Cell Mol Med,2019,23(11):7143-7150.
[24] LUO W,HE Y,XU J,et al.Comparison of third-generation sequencing technology and traditional microbiological detection in pathogen diagnosis of lower respiratory tract infection[J].Discov Med,2023,35(176):332-342.
[25] WANG C X,HUANG Z,FANG W,et al.Preliminary assessment of nanopore-based metagenomic sequencing for the diagnosis of prosthetic joint infection[J].Int J Infect Dis,2020,97:54-59.
[26] YU X,JIANG W,HUANG X,et al.Rrna analysis based on long-read high-throughput sequencing reveals a more accurate diagnostic for the bacterial infection of ascites[J].Biomed Res Int,2021,2021:6287280.
[27] HUANG Q,FU A,WANG Y,et al.Microbiological diagnosis of endophthalmitis using nanopore targeted sequencing[J].Clin Exp Ophthalmol,2021,49(9):1060-1068.
[28] PALAN J,NOLAN C,SARANTOS K,et al.Culture-negative periprosthetic joint infections[J].EFORT Open Rev,2019,4(10):585-594.
[29] KALBIAN I,PARK J W,GOSWAMI K,et al.Culture-negative periprosthetic joint infection:prevalence,aetiology,evaluation,recommendations,and treatment[J].Int Orthop,2020,44(7):1255-1261.
[30] 俞曉玲,姜文倩,鄭玲,等.單分子測序技術(shù)及應(yīng)用研究進(jìn)展[J].生物化學(xué)與生物物理進(jìn)展,2020,47(1):5-16.

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備注/Memo

備注/Memo:
基金項(xiàng)目:河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目(LHGJ20210791)
通訊作者:王少華 E-mail:[email protected]
更新日期/Last Update: 1900-01-01