Table IV.
Comparison of diagnostic value among different microbiological tests. This includes a best-case scenario analysis including the two patients censored for sequencing failure as either culture-negative prosthetic joint infection (n = 1) or noninfection (n = 1).
| Positive microbiological test | Prosthetic joint infection (n = 50) | Noninfection (n = 22) | Sensitivity, % (95% CI) | Specificity, % (95% CI) | Positive predictive value, % (95% CI) | Negative predictive value, % (95% CI) |
|---|---|---|---|---|---|---|
| Synovial fluid culture | 30 | 0 | 60.0 (46.2 to 72.4) | 100.0 (85.1 to 100.0) | 100.0 (88.6 to 100.0) | 52.4 (37.7 to 66.6) |
| Comprehensive culture | 39 | 1 | 78.0 (64.8 to 87.2) | 95.5 (78.2 to 99.2) | 97.5 (87.1 to 99.6) | 65.6 (48.3 to 79.6) |
| Synovial fluid mNGS | 47 | 1 | 94.0 (83.8 to 97.9) | 95.5 (78.2 to 99.2) | 97.9 (89.1 to 99.6) | 87.5 (69 to 95.7) |
| Synovial fluid culture or mNGS | 48 | 1 | 96.0 (86.5 to 98.9) | 95.5 (78.2 to 99.2) | 98.0 (89.3 to 99.6) | 91.3 (73.2 to 97.6) |
| Comprehensive culture or synovial fluid mNGS | 49 | 2 | 98.0 (89.5 to 99.6) | 95.5 (78.2 to 99.2) | 98 (89.5 to 99.6) | 95.5 (78.2 to 99.2) |
CI, confidence interval; mNGS, metagenomic next-generation sequencing