Payne C J, Walker T W M, Karcher A M, Kingsmore D B, Byrne D S
Department of General and Vascular Surgery, Gartnavel General Hospital, Glasgow.
Surgeon. 2008 Aug;6(4):204-6. doi: 10.1016/s1479-666x(08)80028-5.
It is common practice to take a specimen of pus for microscopy and bacterial culture during drainage of abscesses. The aim of this study was to determine if routine culture and sensitivity had any therapeutic value in the care of patients with non-perianal cutaneous abscesses.
A retrospective analysis ofall patients undergoing drainage ofa cutaneous abscess during a two year period (June 2003 - June 2005) was performed. Patients were identified from the hospital database and theatre records, and those with perianal, pilonidal or surgical wound sepsis were excluded. Notes were reviewed for clinical details, culture results, subsequent admissions and attendance at follow-up.
Of the 239 patients treated during this period, 74 patients had 77 operations to drain abscesses that matched the inclusion criteria. Specimens were sent from 52 (67.5%) procedures. Only 65.4% had an organism identified, of which methicillin-sensitive Staphylococcus aureus (MSSA) was the most commonly isolated organism (36.5%). Forty-one point six per cent of patients received antibiotics as part of their treatment. The results of the bacterial culture and antibiotic sensitivities were not known prior to discharge of any patient.
This study shows that bacteriology swabs are frequently taken during incision and drainage of non-perianal cutaneous abscesses and had little impact on the subsequent treatment, though these results may not be applicable to immune-compromised patients.
在脓肿引流过程中采集脓液样本进行显微镜检查和细菌培养是常见的做法。本研究的目的是确定常规培养和药敏试验对非肛周皮肤脓肿患者的护理是否具有任何治疗价值。
对在两年期间（2003年6月至2005年6月）接受皮肤脓肿引流的所有患者进行回顾性分析。从医院数据库和手术记录中识别患者，排除患有肛周、藏毛窦或手术伤口败血症的患者。查阅病历以获取临床细节、培养结果、后续入院情况和随访就诊情况。
在此期间接受治疗的239例患者中，74例患者进行了77次符合纳入标准的脓肿引流手术。52例（67.5%）手术送检了样本。仅65.4%的样本鉴定出了病原体，其中对甲氧西林敏感的金黄色葡萄球菌（MSSA）是最常分离出的病原体（36.5%）。41.6%的患者接受了抗生素治疗作为其治疗的一部分。在任何患者出院前，细菌培养和抗生素敏感性结果均未知。
本研究表明，在非肛周皮肤脓肿切开引流过程中经常进行细菌学拭子检查，但对后续治疗影响不大，不过这些结果可能不适用于免疫功能低下的患者。
