Next Generation Sequencing for the Detection of Pathogens in Hip Surgery: Experience and Diagnostic Feasibility in a Tertiary Care Center in Argentina

  • Carlos Martín Lucero Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0003-1325-7027
  • Agustín García-Mansilla Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0001-9820-8886
  • Agustín Albani Forneris Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-9463-2724
  • Fernando Díaz Dilernia Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-7830-2207
  • Pablo Slullitel Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-8957-075X
  • Gerardo Zanotti Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0001-8090-4832
  • Fernando Comba Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-2848-2983
  • Francisco Piccaluga Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-9887-4886
  • Martín Buttaro Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0003-3329-778X
DOI: https://doi.org/10.15417/issn.1852-7434.2022.87.5.1571
Keywords: Periprosthetic joint infection, next generation sequencing, revision surgery, hip arthroplasty

Abstract

Introduction: Early diagnosis of a periprosthetic joint infection (PJI) and identification of the pathogen are paramount. Next-generation sequencing (NGS) can identify the nucleic acids in a given germ in a short period. To our knowledge, there are no reports of its use in the management of PJI in South America. Our objective was to demonstrate the diagnostic feasibility of the NGS technique on the samples obtained from a series of patients operated on in Buenos Aires, Argentina. Materials and Methods: A prospective series of 20 patients undergoing septic and aseptic hip revision surgery from December 2019 to March 2020 was analyzed. Intraoperative samples of synovial fluid, deep tissue, and intramedullary canal were obtained and sent to the NexGen Microgen laboratory (Texas, USA) for analysis. Results: Seventeen patients were finally eligible to present a sample suitable for analysis. In 100% of the samples, NGS results were obtained within 72 hours of surgery. In one case, the NGS result reported agerm different from the one identified in the postoperative soft tissue cultures, allowing antibiotic therapy to be corrected. In another case, NGS identified Parabacteroides gordonii in aseptic revision surgery. In another patient, the NGS identified Morganella morganii, in which conventional postoperative cultures were negative in single-stage revision surgery. Conclusion: In this study, we demonstrated the diagnostic feasibility of NGS, obtaining results within 72 hours immediately after surgery for pathogenic organisms in patients with PJI and negative cultures.

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Author Biographies

Carlos Martín Lucero, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Agustín García-Mansilla, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Agustín Albani Forneris, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Fernando Díaz Dilernia, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Pablo Slullitel, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Gerardo Zanotti, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Fernando Comba, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Francisco Piccaluga, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Martín Buttaro, Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Institute of Orthopedics and Traumatology “Prof. Dr Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

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Published
2022-10-24
How to Cite
Lucero, C. M., García-Mansilla, A., Albani Forneris, A., Díaz Dilernia, F., Slullitel, P., Zanotti, G., Comba, F., Piccaluga, F., & Buttaro, M. (2022). Next Generation Sequencing for the Detection of Pathogens in Hip Surgery: Experience and Diagnostic Feasibility in a Tertiary Care Center in Argentina. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(5), 626-635. https://doi.org/10.15417/issn.1852-7434.2022.87.5.1571
Issue
Vol 87 No 5 (2022): ACARO
Section
Clinical Research
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