{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T01:03:04Z","timestamp":1793149384443,"version":"4.5.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,7,17]],"date-time":"2021-07-17T00:00:00Z","timestamp":1626480000000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Osteoarticular infections (OAIs) are frequently encountered in children. Treatment may be guided by isolation of a pathogen; however, operative cultures are often negative. Metagenomic next-generation sequencing (mNGS) allows for broad and sensitive pathogen detection that is culture-independent. We sought to evaluate the diagnostic utility of mNGS in comparison to culture and usual care testing to detect pathogens in acute osteomyelitis and\/or septic arthritis in children.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a single-site study to evaluate the use of mNGS in comparison to culture to detect pathogens in acute pediatric osteomyelitis and\/or septic arthritis. Subjects admitted to a tertiary children\u2019s hospital with suspected OAI were eligible for enrollment. We excluded subjects with bone or joint surgery within 30 days of admission or with chronic osteomyelitis. Operative samples were obtained at the surgeon\u2019s discretion per standard care (fluid or tissue) and based on imaging and operative findings. We compared mNGS to culture and usual care testing (culture and polymerase chain reaction [PCR]) from the same site.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We recruited 42 subjects over the enrollment period. mNGS of the operative samples identified a pathogen in 26 subjects compared to 19 subjects in whom culture identified a pathogen. In 4 subjects, mNGS identified a pathogen where combined usual care testing (culture and PCR) was negative. Positive predictive agreement and negative predictive agreement both were 93.0% for mNGS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this single-site prospective study of pediatric OAI, we demonstrated the diagnostic utility of mNGS testing in comparison to culture and usual care (culture and PCR) from operative specimens.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofab346","type":"journal-article","created":{"date-parts":[[2021,7,17]],"date-time":"2021-07-17T13:09:01Z","timestamp":1626527341000},"source":"Crossref","is-referenced-by-count":39,"title":["Use of Metagenomic Next-Generation Sequencing to Identify Pathogens in Pediatric Osteoarticular Infections"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2982-8031","authenticated-orcid":false,"given":"Nanda","family":"Ramchandar","sequence":"first","affiliation":[{"name":"Pediatric Infectious Disease, University of California, San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Burns","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics, University of California, San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole G","family":"Coufal","sequence":"additional","affiliation":[{"name":"Pediatric Critical Care, University of California, San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Pennock","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics, University of California, San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Briggs","sequence":"additional","affiliation":[{"name":"IDbyDNA, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Stinnett","sequence":"additional","affiliation":[{"name":"IDbyDNA, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Bradley","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease, University of California, San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Arnold","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease, University of California, San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George Y","family":"Liu","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease, University of California, San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Pring","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics, University of California, San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidyadhar V","family":"Upasani","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics, University of California, San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Rickert","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics, University of California, San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Dimmock","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Institute for Genomic Medicine, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Chiu","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauge","family":"Farnaes","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease, University of California, San Diego, San Diego, California, USA"},{"name":"IDbyDNA, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Cannavino","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease, University of California, San Diego, San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,7,17]]},"reference":[{"key":"2021072712511362500_CIT0001","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.idc.2015.05.012","article-title":"Osteoarticular infections in children","volume":"29","author":"Arnold","year":"2015","journal-title":"Infect Dis Clin North Am"},{"key":"2021072712511362500_CIT0002","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1097\/BPO.0000000000000332","article-title":"Pediatric acute hematogenous osteomyelitis","volume":"35","author":"Street","year":"2015","journal-title":"J Pediatr Orthop"},{"key":"2021072712511362500_CIT0003","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1097\/INF.0b013e3181f55a75","article-title":"Acute hematogenous osteomyelitis in children: differences in clinical manifestations and management","volume":"29","author":"Kaplan","year":"2010","journal-title":"Pediatr Infect Dis 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