期刊
BONE & JOINT RESEARCH
卷 8, 期 8, 页码 367-377出版社
BRITISH EDITORIAL SOC BONE & JOINT SURGERY
DOI: 10.1302/2046-3758.88.BJR-2019-0003.R2
关键词
Prosthetic joint infection; 16S metagenomics; Synovial fluid; Bacterial composition; Polymicrobial infection
资金
- Ministry of Science and Technology, Taiwan [MOST 108-2320-B-182A-020 -MY3, MOST 107-2314-B-182A-036 -MY3]
- Chang Gung Memorial Hospital [CRRPG3H0051, CRRPG3H0052, CRRPG3H0053, CMRPG3H1311, CMRPG3H1312, CMRPG3H1313]
Objectives Prosthetic joint infection (PJI) is the most common cause of arthroplasty failure. However, infection is often difficult to detect by conventional bacterial cultures, for which false-negative rates are 23% to 35%. In contrast, 16S rRNA metagenomics has been shown to quantitatively detect unculturable, unsuspected, and unviable pathogens. In this study, we investigated the use of 16S rRNA metagenomics for detection of bacterial pathogens in synovial fluid (SF) from patients with hip or knee PJI. Methods We analyzed the bacterial composition of 22 SF samples collected from 11 patients with PJIs (first- and second-stage surgery). The V3 and V4 region of bacteria was assessed by comparing the taxonomic distribution of the 16S rDNA amplicons with microbiome sequencing analysis. We also compared the results of bacterial detection from different methods including 16S metagenomics, traditional cultures, and targeted Sanger sequencing. Results Polymicrobial infections were not only detected, but also characterized at different time-points corresponding to first- and second-stage exchange arthroplasty. Similar taxonomic distributions were obtained by matching sequence data against SILVA, Greengenes, and The National Center for Biotechnology Information (NCBI). All bacteria isolated from the traditional culture could be further identified by 16S metagenomics and targeted Sanger sequencing. Conclusion The data highlight 16S rRNA metagenomics as a suitable and promising method to detect and identify infecting bacteria, most of which may be uncultivable. Importantly, the method dramatically reduces turnaround time to two days rather than approximately one week for conventional cultures.
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