Case ReportsNext-Generation Sequencing Quickly Identifies Mycobacterium smegmatis in Spine Implant Infection A Case ReportClarkson, Samuel J. MD∗; Goswami, Karan MD∗; Paziuk, Taylor MD∗; Belden, Katherine A. MD†; Hilibrand, Alan S. MD∗; Parvizi, Javad MD, FRCS∗Author Information From the ∗Rothman Orthopaedic Institute at Thomas Jefferson University †Division of Infectious Diseases, Thomas Jefferson University Hospital, Philadelphia, PA. Correspondence to: Samuel J. Clarkson, MD, Rothman Orthopaedic Institute, 125 S 9th St Ste 1000, Philadelphia, PA 19107. E-mail: [email protected]. The authors have no funding or conflicts of interest to disclose. Infectious Diseases in Clinical Practice: November 2021 - Volume 29 - Issue 6 - p e451-e453 doi: 10.1097/IPC.0000000000001018 Buy Metrics Abstract We present the case of a 62-year-old woman who underwent revision surgery because of screw displacement after C1 to C3 laminectomy and occiput to C5 posterior fusion. Culture of tissue obtained intraoperatively grew nontuberculous mycobacteria (NTM) in 5 days; however, a specific species was not identified using culture until 5 weeks after sample collection. In contrast, next-generation sequencing analysis performed on samples obtained during a subsequent irrigation and debridement confirmed the presence of Mycobacterium smegmatis within 1 week. Although traditional culture identified a rapidly growing NTM in this case of spine implant infection, the species was not identified in a timely manner. Accurate and rapid species-level pathogen identification is imperative in the targeted treatment of NTM infections including spine implant infection. The use of molecular testing, such as next-generation sequencing, is helpful in identifying infecting organisms and guiding antimicrobial treatment. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.