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Next-Generation Sequencing Supports Targeted Antibiotic Treatment for Culture Negative Orthopedic Infections

Authors/contributors
Abstract
The isolation of an infective pathogen can be challenging in some patients with active, clinically apparent infectious diseases. Despite efforts in the microbiology lab to improve the sensitivity of culture in orthopedic implant-associated infections, the clinically relevant information often falls short of expectations. The management of peri-prosthetic joint infections (PJI) provides an excellent example of the use and benefits of newer diagnostic technologies to supplement the often-inadequate yield of traditional culture methods as a substantial percentage of orthopedic infections are culture-negative. Next-generation sequencing (NGS) has the potential to improve upon this yield. Bringing molecular diagnostics into practice can provide critical information about the nature of the infective organisms and allow targeted therapy in these otherwise challenging situations. This review article describes the current state of knowledge related to the use and potential of NGS to diagnose infections, particularly in the setting of PJIs.
Publication
Clinical Infectious Diseases
Date
2023-01-13
Notes

Summary:

This article highlights the limitations of traditional culture methods in diagnosing infectious diseases, particularly in orthopedic infections. It explores the use of molecular diagnostic methods, such as polymerase chain reaction (PCR) and next-generation sequencing (NGS), as alternatives. PCR offers targeted amplification of pathogenic DNA, while NGS provides comprehensive sequencing of genetic material. NGS has shown promise in detecting rare and fastidious bacteria, identifying unusual microorganisms, and improving targeted antibiotic therapy. However, challenges in implementation and the need for further validation studies remain. Despite these challenges, NGS is considered a valuable tool in identifying infecting organisms that are often missed by traditional culture techniques. Its use requires collaboration between medical professionals and training in molecular technology. NGS has the potential to revolutionize clinical microbiology by replacing labor-intensive methods with a single diagnostic test.

Citation
1.
Kullar R, Chisari E, Snyder J, Cooper C, Parvizi J, Sniffen J. Next-Generation Sequencing Supports Targeted Antibiotic Treatment for Culture Negative Orthopedic Infections. Goldstein EJC, ed. Clinical Infectious Diseases. 2023;76(2):359-364.