Diagnostic Efficacy of Metagenomic Next-Generation Sequencing in Patients with Spinal Infections: A Retrospective Study

Abstract

Purpose

Early diagnosis of spinal infections remains challenging, and emerging metagenomic next-generation sequencing (mNGS) technology holds promise in addressing this issue. The aim of this study is to investigate the diagnostic efficacy of mNGS in spinal infections.

Patients and Methods

A total of 78 cases with suspected spinal infections were enrolled in this study, all of whom underwent laboratory, histopathological and mNGS examinations upon admission. Lesion samples were obtained by surgical or C-arm-guided puncture. Sensitivity, specificity, positive predictive value and negative predictive value of culture and mNGS were calculated for statistical analysis.

Results

With histopathological results as the reference, the included 78 patients were categorized into 50 cases in the spinal infection group and 28 cases in the aseptic group. The sensitivity (84%) and negative predictive value (77.14%) of mNGS were significantly higher than those of culture (32% and 44.26%, respectively), whereas no significant differences were observed in terms of specificity and positive predictive value. In the subgroup analysis for Mycobacterium tuberculosis, the sensitivity of mNGS (90.91%) and T-spot (90.91%) was significantly higher than that of culture (0). Additionally, mNGS demonstrated markedly higher specificity (100%) compared to T-spot (85.07%).

Conclusion

This study underscores the substantial advantages of mNGS in terms of diagnostic accuracy and bacterial coverage for spinal infections. The findings provide compelling clinical evidence that supports the enhanced diagnostic efficacy of mNGS.

Keywords:

• culture
• diagnosis
• sensitivity
• specificity
• bacteria
• clinical evidence

Data Sharing Statement

If necessary, data can be obtained from the corresponding author upon resonable request.

Ethical Approval and Consent to Participate

All procedures were performed in compliance with relevant laws and institutional guidelines and that the medical ethics committee of Sun Yat-Sen Memorial Hospital of Sun Yat-sen University has approved them (SYSKY-2023-1095-01). At the time of admission for each patient, we have obtained informed consent from all patients. Authors confirmed that the present study strictly adheres to the relevant provisions of the Declaration of Helsinki.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

Professor Li has received funding from Guangzhou Science and technology projects (Grant numbers: 202102010259). Doctor Liu has received funding from Jointly Sponsored Project by Municipal and University (Institute) Foundation for Basic and Applied Basic Research (Grant numbers: 202201020531).