Background
Materials and methods
Study design and data sources
Study selection
Data collection and risk-of-bias assessment
Statistical analysis
Results
Systematic review
Study | Study design | Setting | Period | Country of study | Participants | Sample Size | Previous antibiotic | Sample types | NGS positive predictive value |
---|---|---|---|---|---|---|---|---|---|
Thoendel M, 2018 | Prospective study | Single-center | 2011–2016 | US | Patients who underwent revision arthroplasties | n = 213 | n = 131 | Sonicated fluid | NR |
Ivy M, 2018 | Prospective Study | Single-center | Apr 1998–Jun 2018 | US | Patients who underwent revision knee procedures | n = 107 | n = 46 | Synovial fluid | NR |
Tarabichi M, 2018 | Prospective Study | Single-center | Jun–Nov 2016 | US | Patients who underwent revision arthroplasties | n = 28 | n = 28 | Synovial fluid | NR |
Zhang C, 2019 | Prospective Study | Single-center | Dec 2016–Dec 2018 | China | Patients who underwent revision arthroplasties | n = 24 | n = 15 | Synovial fluid; Sonicated fluid; NGS, sonicated fluid | 96% |
Huang Z, 2020 | Prospective Study | Single-center | Mar 2017–Jul 2018 | China | Patients who underwent revision arthroplasties | n = 49 | n = 18 | Synovial fluid; sonicated fluid; NGS, synovial fluid | 97.9% |
Flurin L, 2021 | Retrospective Study | Single-center | 2007–2019 | US | Patients who underwent revision of a total elbow arthroplasty | n = 47; synovial culture, n = 15 | n = 19 | Synovial fluid; sonicated fluid; NGS, sonicated fluid | 98.0% |
He R, 2021 | Prospective Study | Single-center | Oct 2017–Apr 2019 | China | Patients who underwent revision arthroplasties | n = 40 | n = 9 | Synovial fluid; sonicated fluid; NGS, sonicated fluid | 94.7% |
Yin H, 2021 | Retrospective study | Single-center | Jul 2017–Dec 2019 | China | Patients who underwent revision arthroplasties | n = 15 | NR | Synovial fluid | 88% |
Hong HL, 2023 | Retrospective study | Single-center | 2011–2016 | US | Patients who underwent resection arthroplasties | n = 208 | n = 128 | Sonicated fluid | NR |
Study | Methodology | |
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NGS | Culture | |
Thoendel M, 2018 | Sonicated fluid samples performed microbial DNA enrichment using the MolYsis Basic5 kit (Molzym, Bremen, Germany). DNA extraction and whole genome amplification was performed using MoBio Bacteremia DNA isolation kits (Qiagen, Hilden, Germany) and the Qiagen REPLI-g Single Cell kit, respectively. Agencourt Ampure XP beads (Beckman Coulter, Brea, CA) and TE pH 8.0 (Integrated DNA Technologies, Coralville, IA) were used for purifying amplified DNA. Samples were sequenced with the Illumina HiSeq 2500 (Illumina, San Diego, CA) | Sonicate fluids were prepared from resected prosthetic hip and knee components using vortex and sonication methods previously described (aerobic and anaerobic cultures) |
Ivy M, 2018 | Synovial fluid samples performed microbial DNA enrichment using a MolYsis Basic5 kit (Molzym, Bremen, Germany). The pelleted bacteria were subjected to DNA extraction and isolation using a MoBio Bacteremia DNA isolation kit (Qiagen, Hilden, Germany). Whole-genome amplification was carried out using a Qiagen REPLI-g Single Cell kit (Qiagen) according to the manufacturer’s instructions. Amplified DNA was purified using Agencourt Ampure XP beads (Beckman Coulter, Brea, CA) according to the manufacturer’s protocol with elution in Tris–EDTA (TE) buffer, pH 8.0 (Integrated DNA Technologies, Coralville, IA) | Synovial fluid samples with a volume of over 1 ml was inoculated into a BD Bactec Peds Plus/F bottle and incubated for 5 d on a Bactec 9240 instrument prior to November 2012 and on a Bactec FX instrument (BD Diagnostic Systems, Sparks, MD) after November 2012. Synovial fluid samples with a volume of < 1 ml were put onto 5% sheep blood agar and BBL Chocolate II agar and into BBL fluid thioglycolate medium (BD Diagnostic Systems, Sparks, MD), which was followed by incubation at 35–37 °C for 5 d. In anaerobic culture, anaerobic Remel thioglycolate broth without indicator with vitamin K and hemin (Thermo Fisher Scientific, Lenexa, KS) was inoculated and incubated for 7–14 d, and BBL Centers for Disease Control and Prevention anaerobe 5% sheep blood agar (BD Diagnostic Systems) was inoculated and incubated anaerobically at 35–37 °C for 7–14 d |
Tarabichi M, 2018 | The DNA was amplified using PCR and sequenced on the Ion Torrent Personal Genome Machine system sequencing platform (Thermo Fisher Scientific). The generated sequences were read using the National Institutes of Health GenBank database | The routine cultures including aerobic and anaerobic bacterial cultures were performed |
Zhang C, 2019 | The DNA was extracted using the TIANamp Micro DNA Kit (DP316, Tiangen Biotech). DNA libraries were sequenced using the standard protocol of the BGISEQ-500 sequencing platform (BGITianjin, Tianjin, China). The reference genomes in the database were downloaded from the National Center for Biotechnology Information | Synovial and sonicated fluid were tested by Gram staining and acid-fast staining, followed by putting on blood agar plates. The remaining synovial and sonicated fluid were injected into BACTEC Peds Plus/F culture bottles (Becton Dickinson, Germany) and cultured in the BACTEC 9050 Culture System (Becton Dickinson, Germany). The cultures were incubated at 37 °C for 5 d (aerobic cultures) and 14 d (anaerobic cultures) |
Huang Z, 2020 | DNA libraries were sequenced using the BGISEQ-500 platform (BGI-Wuhan, Wuhan, China) | The implants were putting into 500 mL saline solution (Chimin Health Management, Taizhou, China), and the solutions spun for 30 s, followed by sonication for 3 min at 40 kHz (Woxing, Wuxi, China). Each 50 mL of sonicated fluid was concentrated to a final volume of 1 mL by centrifugation (1490×g for 10 min). The samples were cultivated for 6 d (aerobe) and at least 14 d (anaerobe) |
Flurin L, 2021 | All amplified samples underwent sequencing and were processed using a library preparation, normalization, and sequencing protocol from Illumina. The library (600 mL) was submitted to sequencing on an Illumina MiSeq with a 500 cycle V2 Nano kit (Illumina) | Culture results were collected through retrospective review of the electronic medical record (aerobic and anaerobic cultures) |
He R, 2021 | The processing the sample, nucleic acid extraction, construction of DNA libraries, sequencing and bioinformatic analysis were performed | Synovial and sonicated fluid were sent for routine testing including aerobic and anaerobic cultures and cultivated in a blood culture BD bottle on the BD- BACTEC-9120–9240 instrument (BD, Switzerland) up to 14 d |
Yin H, 2021 | DNA was extracted using the TIANamp Micro DNA Kit. The extracted DNA was quantified by Qubit 2.0, and then the samples were subjected to 20 M 50-bp single-end sequencing on the BGISEQ-50 platform. Sequencing data were classified by simultaneously aligning to four Microbial Genome Databases (NCBI) | The fluid was cultivated in aerobic, anaerobic, and blood culture bottles and cultivated for 14 d, respectively |
Hong HL, 2023 | DNA was extracted on a MagNA Pure 96 system. The extracted DNA was amplified by PCR on a LightCycler 480 II. Libraries were sequenced using a 2 × 250 V2 nano kit on an Illumina MiSeq | Samples were cultivated in an aerobic and an anaerobic sheep blood agar plate at 35 ℃ in 5–7% CO2 for 5 d (aerobe) and 14 d (anaerobe), respectively |
Study | Selection of participants | Confounding variables | Measurement of exposure | Building of outcome assessment | Incomplete outcome data | Selective outcome reporting |
---|---|---|---|---|---|---|
Ivy M, 2020 | Low risk | Low risk | Low risk | High risk | Low risk | Low risk |
Tarabichi M, 2018 | Low risk | Low risk | Low risk | High risk | Low risk | Low risk |
Thoendel M, 2018 | Low risk | Low risk | Low risk | High risk | Low risk | Low risk |
Zhang C, 2019 | Low risk | Low risk | Low risk | High risk | Low risk | Low risk |
Huang Z, 2020 | Low risk | Low risk | Low risk | High risk | Low risk | Low risk |
Flurin L, 2021 | Low risk | Low risk | Low risk | Low risk | Low risk | Low risk |
He R, 2021 | Low risk | Low risk | Low risk | High risk | Low risk | Low risk |
Yin H, 2021 | Low risk | Low risk | Low risk | High risk | Low risk | Low risk |
Hong HL, 2023 | Low risk | Low risk | Low risk | High risk | Low risk | Low risk |