Objective To investigate the value of metagenomic second-generation sequencing(mNGS)technique in the diagnosis and treatment of Brucellar spondylitis.Methods The 36 patients with Brucellar spondylitis were treated surgically.Preoperative blood samples and intraoperative tissue samples(nucleus pulposus,cartilage endplate,ligamen-tum flavum,annulus fibrosus)were collected.Giemsa staining,tube agglutination test(SAT),blood culture,multiple polymerase chain reaction(PCR)and mNGS were used to evaluate different tissue samples.Another 30 patients with disc herniation were selected as negative control group.Results There were no statistical significance in the positive rate of mNGS,SAT and multiple PCR in venous blood(P>0.05).There was no statistical difference between the positive rate of mNGS in nucleus pulposus and that of multiple PCR(P>0.05).The positive rate of mNGS in carti-lage endplate,ligamenta flavum and annulus fibrosus were higher than those in multiplex PCR(P<0.05).The posi-tive rate of multiplex PCR and mNGS in nucleus pulposus was higher than that in venous blood,cartilaginous end-plate,ligamentum flavum and annulus fibrosus(P<0.05).Sensitivity,negative predictive value:mNGS were higher than Giemsa staining,blood culture and SAT(P<0.05).There was no statistical difference between mNGS and mul-tiple PCR detection(P>0.05).Consistent clinical diagnosis of mNGS was the best,multiplex PCR and SAT were better,Giemsa staining was common,and blood culture was poor.Conclusions mNGS can be used as an effective de-tection method for Brucellar spondylitis,with high sensitivity and accuracy.It is especially suitable for patients who cannot be clearly diagnosed before surgery and whose postoperative pathological results are negative but need to be confirmed,and can provide important etiological basis for accurate treatment of Brucellar spondylitis.
维普
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