Wormser G P, Forseter G, Cooper D, Nowakowski J, Nadelman R B, Horowitz H, Schwartz I, Bowen S L, Campbell G L, Goldberg N S
Department of Medicine, Westchester County Medical Center, New York Medical College, Valhalla 10595.
JAMA. 1992 Sep 9;268(10):1311-3.
Determining the microbial cause of cellulitis is often difficult. In this study, a novel two-needle lavage technique was used to culture Borrelia burgdorferi from the skin of suspected erythema migrans lesions.
The yield of lavage cultures for B burgdorferi was compared with that of a 2-mm skin biopsy sample.
A Lyme disease diagnostic center located in an area in which Lyme disease is epidemic.
Forty-five patients with suspected erythema migrans who had not been treated with antimicrobial agents.
Cutaneous lavage of the advancing edge of a suspected primary erythema migrans lesion was done for all 45 participants, 33 of whom also had a skin biopsy of the same lesion at an identical (14) or an adjacent (19) site.
Growth of B burgdorferi in in vitro culture.
Lavage fluid cultures grew B burgdorferi in 13 (29%) of the 45 cases (95% confidence interval [CI], 16% to 44%). Among the 33 cases in which both lavage and skin biopsy cultures were done, the yield of lavage culture was less than that of biopsy culture (P less than .09, 12/33 vs 20/33). If contaminated cultures are excluded, this difference is significant (P less than .05, 12/30 vs 20/27).
Cutaneous lavage is a new diagnostic technique for recovery of B burgdorferi from erythema migrans lesions that has potential applicability to other types of cutaneous infections.
确定蜂窝织炎的微生物病因往往很困难。在本研究中，一种新型双针灌洗技术被用于从疑似游走性红斑病变的皮肤中培养伯氏疏螺旋体。
将伯氏疏螺旋体灌洗培养物的产量与2毫米皮肤活检样本的产量进行比较。
位于莱姆病流行地区的一个莱姆病诊断中心。
45名疑似游走性红斑且未接受过抗菌药物治疗的患者。
对所有45名参与者的疑似原发性游走性红斑病变的前沿进行皮肤灌洗，其中33人还在相同（14例）或相邻（19例）部位对同一病变进行了皮肤活检。
伯氏疏螺旋体在体外培养中的生长情况。
45例中有13例（29%）灌洗液培养出伯氏疏螺旋体（95%置信区间[CI]，16%至44%）。在同时进行灌洗和皮肤活检培养的33例中，灌洗培养的产量低于活检培养（P<0.09，12/33对20/33）。如果排除污染培养物，这种差异具有统计学意义（P<0.05，12/30对20/27）。
皮肤灌洗是一种从游走性红斑病变中获取伯氏疏螺旋体的新诊断技术，可能适用于其他类型的皮肤感染。
