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The microbial spectra and detection performance between mNGS and the culturing-based method were compared, and the effects of antibiotic intervention and biopsy on the detection performance were assessed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The microorganisms isolated most commonly via the culturing-based method were <jats:italic>Mycobacterium tuberculosis<\/jats:italic> (n\u2009=\u200921), followed by <jats:italic>Staphylococcus epidermidis<\/jats:italic> (n\u2009=\u200913). The most common microorganisms detected via mNGS were <jats:italic>Mycobacterium tuberculosis complex (MTBC)<\/jats:italic> (n\u2009=\u200939), followed by <jats:italic>Staphylococcus aureus<\/jats:italic> (n\u2009=\u200915). The difference in the type of detected microorganisms between culturing and mNGS was observed only in <jats:italic>Mycobacterium<\/jats:italic> (<jats:italic>P<\/jats:italic>\u2009=\u20090.001). mNGS helped identify potential pathogens in 80.9% of cases, which was significantly higher than the positivity rate of 59.6% observed for the culturing-based method (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Moreover, mNGS had a sensitivity of 85.7% (95% CI, 78.4% to 91.3%), a specificity of 86.7% (95% CI, 59.5% to 98.3%), and sensitivity gains of 35% (85.7% vs. 50.8%; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) during culturing, while no differences were observed in the specificity (86.7% vs. 93.3%; <jats:italic>P<\/jats:italic>\u2009=\u20090.543). In addition, antibiotic interventions significantly lowered the positivity rate of the culturing-based method (66.0% vs. 45.5%, <jats:italic>P<\/jats:italic>\u2009=\u20090.021) but had no effects on the results of mNGS (82.5% vs. 77.3%, <jats:italic>P<\/jats:italic>\u2009=\u20090.467).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The use of mNGS could result in a higher detection rate compared to that observed with the culturing-based method in an individual with spinal infection and is particularly valuable for evaluating the effects of a mycobacterial infection or previous antibiotic intervention.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00586-023-07707-3","type":"journal-article","created":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T16:01:51Z","timestamp":1685116911000},"page":"4220-4228","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Pathogen detection in suspected spinal infection: metagenomic next-generation sequencing versus culture"],"prefix":"10.1007","volume":"32","author":[{"given":"Haihong","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minghui","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenghui","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weidong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Ming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongbin","family":"Qu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,5,26]]},"reference":[{"key":"7707_CR1","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.idc.2017.01.003","volume":"31","author":"M Babic","year":"2017","unstructured":"Babic M, Simpfendorfer C (2017) Infections of the spine. 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