Levine B R, Evans B G
Department of Orthopaedics, Georgetown University Medical Center, Washington, DC, USA.
Clin Orthop Relat Res. 2001 Jan(382):222-31. doi: 10.1097/00003086-200101000-00030.
A retrospective study was performed evaluating the results of three different intraoperative culture techniques and their diagnostic value in determining clinical infection in patients after a total joint replacement. Twenty-four patients (34 cases) met the selection criteria and were evaluated using intraoperatively collected tissue samples, swab samples, and fluid samples injected into standard blood culture vials. Results of the cultures of these specimens were compared with the clinical diagnoses to determine specificity, sensitivity, and accuracy of each technique. The current study suggests the use of fluid aspirate from intraoperative wounds immediately injected into blood culture vials is a highly specific, sensitive, and accurate diagnostic culture technique (100%, 92%, and 94%, respectively). The superiority of vial cultures is enhanced when organisms grown from the liquid media only are discounted as contaminants. This led to significant decreases in the sensitivity and accuracy of swab culture and tissue biopsy results when compared with vial culture results. Thus, vial cultures are a more cost-effective means for intraoperative detection of infection.
进行了一项回顾性研究，评估三种不同术中培养技术的结果及其在确定全关节置换术后患者临床感染方面的诊断价值。24例患者（34例病例）符合入选标准，并使用术中采集的组织样本、拭子样本和注入标准血培养瓶的液体样本进行评估。将这些标本的培养结果与临床诊断进行比较，以确定每种技术的特异性、敏感性和准确性。当前研究表明，将术中伤口吸出的液体立即注入血培养瓶是一种高度特异、敏感且准确的诊断培养技术（分别为100%、92%和94%）。当仅将从液体培养基中生长的微生物视为污染物时，培养瓶培养的优势会增强。与培养瓶培养结果相比，这导致拭子培养和组织活检结果的敏感性和准确性显著降低。因此，培养瓶培养是术中检测感染更具成本效益的方法。
