This prospective diagnostic study from the Rothman Institute evaluates whether next-generation sequencing (NGS) — which sequences all DNA in a sample — can identify causative organisms in periprosthetic joint infection (PJI) more reliably than standard culture, with particular focus on culture-negative cases across 65 revision and 17 primary arthroplasties.
When your culture comes back negative but the clinical picture still points to PJI — elevated CRP/ESR, high synovial WBC, sinus tract — NGS can identify a pathogen in ~80% of those cases and help infectious disease tailor targeted therapy rather than relying on empiric coverage.
Interpret NGS positivity cautiously in low-probability cases: a dominant single organism (>59.5% of sample) is far more actionable than a polymicrobial low-abundance result.
This prospective diagnostic study from the Rothman Institute evaluates whether next-generation sequencing (NGS) — which sequences all DNA in a sample — can identify causative organisms in periprosthetic joint infection (PJI) more reliably than standard culture, with particular focus on culture-negative cases across 65 revision and 17 primary arthroplasties.
When your culture comes back negative but the clinical picture still points to PJI — elevated CRP/ESR, high synovial WBC, sinus tract — NGS can identify a pathogen in ~80% of those cases and help infectious disease tailor targeted therapy rather than relying on empiric coverage.
Interpret NGS positivity cautiously in low-probability cases: a dominant single organism (>59.5% of sample) is far more actionable than a polymicrobial low-abundance result.