The Role of Applying Metagenomic Next-Generation Sequencing (mNGS) in Periprosthetic Joint Infection with Sinus Tract: A Retrospective Study

Xuhui Yuan,1– 3,* Qijin Wang,1– 4,* Haiqi Ding,1– 3,* Hongyan Li,1– 3 Xinyu Fang,1– 3 Wenming Zhang,1– 3 Zida Huang1– 3 1Department of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People’s Republic of China; 2Depar...

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Main Authors: Yuan X, Wang Q, Ding H, Li H, Fang X, Zhang W, Huang Z
Format: Article
Language:English
Published: Dove Medical Press 2025-07-01
Series:International Journal of General Medicine
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Online Access:https://www.dovepress.com/the-role-of-applying-metagenomic-next-generation-sequencing-mngs-in-pe-peer-reviewed-fulltext-article-IJGM
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author Yuan X
Wang Q
Ding H
Li H
Fang X
Zhang W
Huang Z
author_facet Yuan X
Wang Q
Ding H
Li H
Fang X
Zhang W
Huang Z
author_sort Yuan X
collection DOAJ
description Xuhui Yuan,1– 3,* Qijin Wang,1– 4,* Haiqi Ding,1– 3,* Hongyan Li,1– 3 Xinyu Fang,1– 3 Wenming Zhang,1– 3 Zida Huang1– 3 1Department of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People’s Republic of China; 2Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, People’s Republic of China; 3Fujian Provincial Institute of Orthopedics, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People’s Republic of China; 4Department of Orthopaedic Surgery, The Affiliated Mindong Hospital of Fujian Medical University, Fuan, 351100, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenming Zhang, Department of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People’s Republic of China, Tel +8613950391800, Email zhangwm0591@fjmu.edu.cn Zida Huang, Department of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People’s Republic of China, Tel +8618106026516, Email huangzida@163.comBackground: Diagnosing periprosthetic joint infection (PJI), especially with sinus tracts, is challenging using traditional cultures. Metagenomic next-generation sequencing (mNGS) offers a culture-independent diagnostic approach. We evaluated mNGS’s role in diagnosing and guiding treatment for PJI with sinus tracts.Methods: This retrospective analysis included 52 PJI patients (2019– 2024). An mNGS group (n=43; 18 sinus PJI, 25 non-sinus PJI) was compared to a non-mNGS control group (n=9; all sinus PJI, culture-diagnosed). We compared pathogen detection rates. For sinus PJI patients (two-stage revision), 2-year cure rates and antibiotic duration were compared between mNGS-guided and non-mNGS-guided therapy.Results: In sinus PJI cases (n=18), mNGS achieved significantly higher pathogen detection (88.9%, 16/18) versus culture (50.0%, 9/18) (Relative Risk [RR] 1.78; P=0.027). mNGS also detected more polymicrobial infections (38.9%, 7/18) compared to culture (5.6%, 1/18) (RR 7.00; P=0.041). For sinus PJI treatment, mNGS-guided therapy yielded a significantly higher 2-year cure rate (94.4%, 17/18) than non-mNGS therapy (55.6%, 5/9) (Absolute Risk Increase 38.9%; RR 1.70; P=0.03). Mean antibiotic duration was significantly shorter with mNGS guidance (35.62 ± 5.42 vs 47.11 ± 6.53 days; difference 11.49 days; P< 0.01), with a trend towards fewer antibiotic-related complications (11.1% vs 55.6%; P=0.23).Conclusion: mNGS significantly improves pathogen detection, especially polymicrobial infections, in sinus tract PJI. mNGS-guided therapy for sinus PJI is associated with substantially improved cure rates and shorter antibiotic duration, highlighting its utility in guiding targeted anti-infection strategies for these complex cases.Keywords: prosthetic joint infection, metagenomic next-generation sequencing, mNGS, sinus tract, bacteria, diagnosis
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spelling doaj-art-145e0b50d7204a43b4cc5840902f559b2025-08-20T02:36:06ZengDove Medical PressInternational Journal of General Medicine1178-70742025-07-01Volume 18Issue 137873795104641The Role of Applying Metagenomic Next-Generation Sequencing (mNGS) in Periprosthetic Joint Infection with Sinus Tract: A Retrospective StudyYuan X0Wang Q1Ding H2Li H3Fang X4Zhang W5Huang Z6Department of Orthopaedic SurgeryDepartment of Orthopaedic SurgeryDepartment of Orthopaedic SurgeryDepartment of Orthopaedic SurgeryDepartment of Orthopaedic SurgeryDepartment of Orthopaedic SurgeryDepartment of Orthopaedic SurgeryXuhui Yuan,1– 3,* Qijin Wang,1– 4,* Haiqi Ding,1– 3,* Hongyan Li,1– 3 Xinyu Fang,1– 3 Wenming Zhang,1– 3 Zida Huang1– 3 1Department of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People’s Republic of China; 2Department of Orthopaedic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, People’s Republic of China; 3Fujian Provincial Institute of Orthopedics, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People’s Republic of China; 4Department of Orthopaedic Surgery, The Affiliated Mindong Hospital of Fujian Medical University, Fuan, 351100, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenming Zhang, Department of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People’s Republic of China, Tel +8613950391800, Email zhangwm0591@fjmu.edu.cn Zida Huang, Department of Orthopaedic Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, People’s Republic of China, Tel +8618106026516, Email huangzida@163.comBackground: Diagnosing periprosthetic joint infection (PJI), especially with sinus tracts, is challenging using traditional cultures. Metagenomic next-generation sequencing (mNGS) offers a culture-independent diagnostic approach. We evaluated mNGS’s role in diagnosing and guiding treatment for PJI with sinus tracts.Methods: This retrospective analysis included 52 PJI patients (2019– 2024). An mNGS group (n=43; 18 sinus PJI, 25 non-sinus PJI) was compared to a non-mNGS control group (n=9; all sinus PJI, culture-diagnosed). We compared pathogen detection rates. For sinus PJI patients (two-stage revision), 2-year cure rates and antibiotic duration were compared between mNGS-guided and non-mNGS-guided therapy.Results: In sinus PJI cases (n=18), mNGS achieved significantly higher pathogen detection (88.9%, 16/18) versus culture (50.0%, 9/18) (Relative Risk [RR] 1.78; P=0.027). mNGS also detected more polymicrobial infections (38.9%, 7/18) compared to culture (5.6%, 1/18) (RR 7.00; P=0.041). For sinus PJI treatment, mNGS-guided therapy yielded a significantly higher 2-year cure rate (94.4%, 17/18) than non-mNGS therapy (55.6%, 5/9) (Absolute Risk Increase 38.9%; RR 1.70; P=0.03). Mean antibiotic duration was significantly shorter with mNGS guidance (35.62 ± 5.42 vs 47.11 ± 6.53 days; difference 11.49 days; P< 0.01), with a trend towards fewer antibiotic-related complications (11.1% vs 55.6%; P=0.23).Conclusion: mNGS significantly improves pathogen detection, especially polymicrobial infections, in sinus tract PJI. mNGS-guided therapy for sinus PJI is associated with substantially improved cure rates and shorter antibiotic duration, highlighting its utility in guiding targeted anti-infection strategies for these complex cases.Keywords: prosthetic joint infection, metagenomic next-generation sequencing, mNGS, sinus tract, bacteria, diagnosishttps://www.dovepress.com/the-role-of-applying-metagenomic-next-generation-sequencing-mngs-in-pe-peer-reviewed-fulltext-article-IJGMProsthetic joint infectionmetagenomic next-generation sequencingmNGSsinus tractBacteriaDiagnosis
spellingShingle Yuan X
Wang Q
Ding H
Li H
Fang X
Zhang W
Huang Z
The Role of Applying Metagenomic Next-Generation Sequencing (mNGS) in Periprosthetic Joint Infection with Sinus Tract: A Retrospective Study
International Journal of General Medicine
Prosthetic joint infection
metagenomic next-generation sequencing
mNGS
sinus tract
Bacteria
Diagnosis
title The Role of Applying Metagenomic Next-Generation Sequencing (mNGS) in Periprosthetic Joint Infection with Sinus Tract: A Retrospective Study
title_full The Role of Applying Metagenomic Next-Generation Sequencing (mNGS) in Periprosthetic Joint Infection with Sinus Tract: A Retrospective Study
title_fullStr The Role of Applying Metagenomic Next-Generation Sequencing (mNGS) in Periprosthetic Joint Infection with Sinus Tract: A Retrospective Study
title_full_unstemmed The Role of Applying Metagenomic Next-Generation Sequencing (mNGS) in Periprosthetic Joint Infection with Sinus Tract: A Retrospective Study
title_short The Role of Applying Metagenomic Next-Generation Sequencing (mNGS) in Periprosthetic Joint Infection with Sinus Tract: A Retrospective Study
title_sort role of applying metagenomic next generation sequencing mngs in periprosthetic joint infection with sinus tract a retrospective study
topic Prosthetic joint infection
metagenomic next-generation sequencing
mNGS
sinus tract
Bacteria
Diagnosis
url https://www.dovepress.com/the-role-of-applying-metagenomic-next-generation-sequencing-mngs-in-pe-peer-reviewed-fulltext-article-IJGM
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