Rapid DNA Sequencing Technology Could Improve Treatment for Fracture-Related Infections

Fracture-related infections are a serious complication after broken bone surgeries, potentially arising at any point during treatment. These infections can significantly prolong recovery, impair bone healing, cause permanent disability or even amputation, and often require repeated surgeries, costing the healthcare system billions annually. Despite progress in orthopedic trauma care, treatment for these infections still fails in about 30% of cases. Now, a new multicenter clinical trial is evaluating whether rapid next-generation DNA sequencing can improve patient outcomes and reduce the rate of treatment failure and recurrent infection.

The study, led by researchers at Indiana University School of Medicine (Indianapolis, IN, USA), is being conducted through the Major Extremity Trauma Research Consortium, which comprises over 80 trauma centers across the U.S. and Canada. The research spans 15 clinical sites and will follow 250 patients, aged 18 to 84, over the course of four years. It brings together a multidisciplinary team of experts in trauma, infectious diseases, and molecular diagnostics. Unlike traditional diagnostic methods such as polymerase chain reaction (PCR) and culture tests — which are limited in their ability to detect a broad range of pathogens — next-generation sequencing reads microbial DNA to comprehensively identify bacteria and fungi present in a sample. This technology offers a more detailed and faster analysis of the infectious agents responsible for complications following orthopedic surgery.

Patients enrolled in the trial will receive standard care alongside next-generation sequencing diagnostics provided by industry partner MicroGenDX (Orlando, FL, USA). Hospital-based infectious disease specialists will use these sequencing results to tailor antibiotic treatment plans for each patient. Treatment effectiveness will then be monitored for one year, aligning with standard care protocols. If successful, this study could transform the management of fracture-related infections by enabling earlier, more precise interventions. Improved diagnostics may lead to fewer re-hospitalizations, less need for repeat surgeries or amputations, more survivors, and major cost savings for healthcare systems. Researchers believe next-generation sequencing may give clinicians more information to help them decide what the best course of action is for individual patients.

"We hope to get more information from the next-generation sequencing diagnostics that will uncover pathogens that would have not been identified by our current standard tools," said Roman M. Natoli, MD, PhD, associate professor of orthopedic surgery in the Department of Orthopedic Surgery at IU School of Medicine and principal investigator of the clinical trial. "This trial will allow us to choose more appropriate antibiotic treatment via next-generation sequencing results and ultimately, if we're correct, reduce the rate of failure for treating patients that have infections after fractures. We hope to not only reduce the failure rate in fracture-related infections but also bring wounded warriors and civilians to more optimal function, where they can return to active duty, work and life."

Related Links:
Indiana University School of Medicine
MicroGenDX