This study investigates the feasibility of using rapid nanopore sequencing for identifying pathogenic bacteria in prosthetic joint infections (PJI). Results demonstrate the technology's accuracy comparable to traditional microbial culture methods, while significantly reducing diagnostic time to provide faster clinical reference.
Literature Overview
The article 'Rapid Nanopore Sequencing to Identify Bacteria Causing Prosthetic Joint Infections' published in Antibiotics reviews current diagnostic challenges for PJI, focusing on limitations of conventional microbial culture including false positives, false negatives, and prolonged culture periods. It further evaluates the application of nanopore sequencing in bacterial identification, assessing its diagnostic accuracy and time efficiency for clinical implementation.
Background Knowledge
Prosthetic joint infection (PJI) is a severe but relatively rare postsurgical complication primarily caused by bacterial biofilm formation, making early pathogen identification difficult using conventional diagnostic methods (e.g., blood tests, imaging, histology, and microbial culture). Currently, microbial culture remains the primary diagnostic tool, but its limited sensitivity and specificity combined with lengthy detection periods hinder timely clinical intervention. Developing rapid, accurate molecular detection methods is therefore critical for early PJI identification and treatment. As a third-generation sequencing technology, nanopore sequencing offers advantages in rapid sequencing and long-read capabilities, demonstrating clinical potential for infection diagnostics. This study evaluates its feasibility for PJI pathogen identification to provide timely auxiliary diagnostic support.
Research Methods and Experiments
The study enrolled 19 patients undergoing joint revision surgery, with 15 confirmed PJI cases according to EBJIS criteria. Intraoperative joint fluid samples were collected for DNA extraction, followed by rapid sequencing using the MinION nanopore sequencing platform. Bioinformatics processing included quality filtering, host DNA removal, species alignment via BLAST, and screening based on sequence length and consistency scores. Sequencing results were compared against microbial culture outcomes to construct a contingency table and calculate diagnostic metrics including accuracy and F1 score.
Key Conclusions and Perspectives
Research Significance and Prospects
This study confirms nanopore sequencing's speed and high sensitivity for PJI pathogen identification. Future optimization should focus on improving specificity through enhanced sequencing protocols and bioinformatics analysis strategies. The technology demonstrates broad application potential for clinical sample processing, multicenter validation, and prospective studies with expanded cohorts, positioning it as an effective complementary tool to traditional microbial culture.
Conclusion
This study validates rapid nanopore sequencing as a clinically applicable method for PJI pathogen identification, demonstrating superior accuracy and significant time advantages. While current limitations include false-positive/negative results, combination with traditional microbial culture substantially enhances diagnostic reliability. As a third-generation sequencing technology, nanopore sequencing offers real-time, rapid, and high-throughput capabilities, promising greater impact in clinical infectious disease diagnostics - particularly for scenarios requiring urgent pathogen identification and treatment guidance.
