DIAGNOSTIC EFFICACY OF METAGENOMIC NEXT-GENERATION SEQUENCING (mNGS) FOR SPINAL INFECTION

Metagenomic next-generation sequencing (mNGS) has the potential to improve or enhance how many difficult-to-detect pathogens are identified in cases of spinal infection (SI). This study aims to evaluate mNGS as a diagnostic tool in detecting pathogens from biopsy specimens of SI patients. Concordance along with the significance of differences between diagnostic studies were calculated. All patients diagnosed with clinical suspicion of SI were enrolled, and data were collected through a retrospective chart review of patient records. Biopsy specimens obtained from each patient were tested via mNGS and microbial culture. The results of mNGS and microbial culture were compared. Diagnostic concordance between mNGS and culture was calculated. A total of 23 patients (14 men and 9 women) were deemed suitable for enrollment. The overall sensitivity of mNGS was 65.2% (15/23), which was significantly higher than that of microbial culture, with a sensitivity of 34.7% (8/23, p = 0.016). mNGS was able to detect 100% (8/8) of pathogens identified by conventional culture, with a genus-level sensitivity of 100% (8/8) and a species-level sensitivity of 87.5%. The kappa value demonstrated moderate agreement between the two detection methods (kappa = 0.443, p = 0.011). Thirteen potential pathogens in 7 of 15 culture-negative SIs were also detected by mNGS. The present work demonstrated that mNGS is probably superior to microbial culture in detecting SI pathogens. Additional studies of more gene content information, including resistance mechanisms and antibiotic susceptibility, may guide clinicians in the design of different treatment strategies and improve clinical practice.