Illgner U, Krenn V, Osada N, Bause L
Klinik für Rheumaorthopädie, St. Josef Stift Sendenhorst, Westtor 7, 48324, Sendenhorst, Deutschland.
Z Rheumatol. 2013 Sep;72(7):709-13. doi: 10.1007/s00393-013-1173-2.
It can be difficult to distinguish between synovitis due to rheumatism and synovitis due to a bacterial infection. Microbiological detection of bacteria is not always successful and the clinical significance of low virulent bacteria often remains uncertain. Therefore, the histopathological finding of inflammatory reactions is very important.
From patients with clinically clear signs of infections and rheumatoid arthritis who underwent surgery between April and August 2011, samples were taken during surgery. Histopathological diagnosis was carried out by conventional enzyme and immunohistochemical techniques based on defined criteria of bacterial infection in tissues, synovial tissue and bone.
A total of 20 patients were included, 10 males and 10 females with a mean age of 61.7 years. Staphylococcus aureus was the most commonly detected bacteria and in 4 cases bacteria could not be demonstrated. The correlation between the histopathological signs of an infection and microbiological detection of bacteria was 93.3 %.
In patients with rheumatoid arthritis the combination of histopathology and microbiology significantly increased the safety of detecting an infection or contamination.
区分风湿性滑膜炎和细菌性感染所致滑膜炎可能存在困难。细菌的微生物学检测并非总能成功，低毒力细菌的临床意义往往仍不明确。因此，炎症反应的组织病理学发现非常重要。
选取2011年4月至8月间接受手术的具有明确临床感染体征和类风湿关节炎患者，在手术过程中采集样本。根据组织、滑膜组织和骨骼中细菌感染的既定标准，采用传统酶法和免疫组化技术进行组织病理学诊断。
共纳入20例患者，男性10例，女性10例，平均年龄61.7岁。金黄色葡萄球菌是最常检测到的细菌，4例未检测到细菌。感染的组织病理学征象与细菌微生物学检测之间的相关性为93.3%。
对于类风湿关节炎患者，组织病理学和微生物学相结合显著提高了检测感染或污染的安全性。
