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[脊椎椎间盘炎的微生物学诊断标准]

[Standards of microbiological diagnostics of spondylodiscitis].

作者信息

Lehner B, Akbar M, Rehnitz C, Omlor G W, Dapunt U, Burckhardt I

机构信息

Department Orthopädie, Unfallchirurgie und Paraplegiologie, Sektion septische Orthopädie, Stiftung Orthopädische Universitätsklinik Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland.

出版信息

Orthopade. 2012 Sep;41(9):702-10. doi: 10.1007/s00132-012-1914-y.

Abstract

In most cases spondylodiscitis is due to a monomicrobial infection caused by hematogenous dissemination of Staphylococcus aureus. There are, however, many other possible pathogens causing spondylodiscitis and the pathogen responsible can only be identified in approximately 50% of cases. This leads to delayed diagnosis and therapy and an increased morbidity and mortality rate. Failures in planning and performing material recovery are often the reason. As pathogen-specific antimicrobial treatment according to the results of susceptibility testing is the main component of interdisciplinary therapy, all available methods for identification of the pathogen, such as blood cultures, intraoperative and computed tomography (CT) guided biopsies of inflammatory fluids and tissues as well as molecular biological methods should be performed to optimize antimicrobial therapy.

摘要

在大多数情况下,脊椎椎间盘炎是由金黄色葡萄球菌经血行播散引起的单一微生物感染所致。然而,还有许多其他可能导致脊椎椎间盘炎的病原体,并且只有约50%的病例能够确定致病病原体。这会导致诊断和治疗延迟,以及发病率和死亡率上升。材料回收计划和实施中的失败往往是原因所在。由于根据药敏试验结果进行病原体特异性抗菌治疗是多学科治疗的主要组成部分,因此应采用所有可用的病原体鉴定方法,如血培养、术中及计算机断层扫描(CT)引导下对炎性液体和组织进行活检以及分子生物学方法,以优化抗菌治疗。

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