Haenle Maximilian, Podbielski Andreas, Ellenrieder Martin, Mundt Andreas, Krentz Helga, Mittelmeier Wolfram, Skripitz Ralf
Department of Orthopaedic Surgery, University Medicine Rostock, Rostock, Germany.
GMS Hyg Infect Control. 2013 Apr 29;8(1):Doc02. doi: 10.3205/dgkh000202. eCollection 2013.
An early detection of possible periprosthetic infection may lead to an earlier and potentially less invasive treatment of infected total knee arthroplasty TKA). The purpose of the present study was to evaluate retrospectively our current, affordable clinical practice of intra-operative swab taking during primary TKA.
A total of 206 primary TKA were analysed retrospectively for intra-operative bacteriology swabs and subsequent periprosthetic infection. All bacteriology swabs were obtained in a standardized manner including a tissue sample. Data was statistically evaluated concerning standard descriptive statistics and using the chi-square test.
Bacteria were identified in 43.4% with coagulase-negative staphylococci being the most frequently isolated pathogens (52.2%). Regarding the contingency tables and chi-squared tests, generally no association was found between positive intra-operative swabs and subsequent periprosthetic infection as well as all other parameters investigated (timing of the antibiotic prophylaxis and pre-operative laboratory results).
Bacteriology swabs during primary total knee arthroplasty are no adequate measure to predict subsequent periprosthetic infections, even if augmented with a tissue sample.
早期发现可能的假体周围感染可能会使感染性全膝关节置换术(TKA)的治疗更早且潜在侵入性更小。本研究的目的是回顾性评估我们目前在初次TKA术中采集拭子的经济可行的临床实践。
回顾性分析206例初次TKA术中的细菌学拭子及随后的假体周围感染情况。所有细菌学拭子均以标准化方式采集,包括组织样本。对数据进行标准描述性统计并使用卡方检验进行统计学评估。
43.4%的样本中鉴定出细菌,凝固酶阴性葡萄球菌是最常分离出的病原体(52.2%)。关于列联表和卡方检验,术中拭子阳性与随后的假体周围感染以及所有其他研究参数(抗生素预防时机和术前实验室结果)之间通常未发现关联。
即使增加组织样本,初次全膝关节置换术中的细菌学拭子也不是预测随后假体周围感染的充分措施。