Orthopaedic Surgery Service, Geneva University Hospitals, 4, Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland.
Eur J Clin Microbiol Infect Dis. 2011 Feb;30(2):279-81. doi: 10.1007/s10096-010-1078-9. Epub 2010 Oct 10.
In this study, we investigate the accuracy of two consecutive ulcer cultures with bone contact compared to bone biopsy for the diagnosis of diabetic toe osteomyelitis. The same nurse and orthopaedic surgeon obtained all samples: sample A-1: bone contact swabbing through the ulcer; sample A-2: a second culture swabbing from the bone surface within 24 h; sample B: surgical bone biopsy in the operating theatre. The kappa statistic measure between samples A-1 and A-2 (bone contact swabs) indicated 82.35% agreement. The sensitivity, specificity, positive and negative predictive values of the two samples A compared to B were 96%, 79%, 92% and 88%, respectively, for the causative pathogen. These results were similar with prior antibiotic treatment, discordant bone surface swabs or with monomicrobial infections. As a conclusion, two consecutive diabetic toe cultures with bone contact accurately predict the pathogen of diabetic toe osteomyelitis in 90% of cases.
在这项研究中，我们研究了连续两次溃疡培养与骨接触与骨活检相比，在诊断糖尿病足骨髓炎方面的准确性。同一名护士和骨科医生采集了所有样本：样本 A-1：通过溃疡进行骨接触拭子；样本 A-2：在 24 小时内从骨表面进行第二次培养拭子；样本 B：手术室中的外科骨活检。样本 A-1 和 A-2（骨接触拭子）之间的 Kappa 统计测量值表明有 82.35%的一致性。与样本 B 相比，两个样本 A 的敏感性、特异性、阳性预测值和阴性预测值分别为 96%、79%、92%和 88%，适用于致病病原体。这些结果与先前的抗生素治疗、骨表面拭子不一致或单微生物感染相似。总之，连续两次糖尿病足溃疡培养与骨接触可在 90%的情况下准确预测糖尿病足骨髓炎的病原体。
