Oliva Alessandra, Miele Maria Claudia, Al Ismail Dania, Di Timoteo Federica, De Angelis Massimiliano, Rosa Luigi, Cutone Antimo, Venditti Mario, Mascellino Maria Teresa, Valenti Piera, Mastroianni Claudio Maria
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Department of Biosciences and Territory, University of Molise, Pesche, Italy.
Front Microbiol. 2021 Oct 29;12:750460. doi: 10.3389/fmicb.2021.750460. eCollection 2021.
Implant-associated infections are characterized by microbial biofilm formation on implant surface, which renders the microbiological diagnosis challenging and requires, in the majority of cases, a complete device removal along with a prolonged antimicrobial therapy. Traditional cultures have shown unsatisfactory sensitivity and a significant advance in the field has been represented by both the application of the sonication technique for the detachment of live bacteria from biofilm and the implementation of metabolic and molecular assays. However, despite the recent progresses in the microbiological diagnosis have considerably reduced the rate of culture-negative infections, still their reported incidence is not negligible. Overall, several culture- and non-culture based methods have been developed for diagnosis optimization, which mostly relies on pre-operative and intra-operative (i.e., removed implants and surrounding tissues) samples. This review outlines the principal culture- and non-culture based methods for the diagnosis of the causative agents of implant-associated infections and gives an overview on their application in the clinical practice. Furthermore, advantages and disadvantages of each method are described.
植入物相关感染的特征是在植入物表面形成微生物生物膜，这使得微生物学诊断具有挑战性，并且在大多数情况下，需要完全移除装置并进行长期的抗菌治疗。传统培养方法的敏感性不尽人意，该领域的一项重大进展是应用超声处理技术从生物膜中分离活细菌以及实施代谢和分子检测。然而，尽管微生物学诊断方面的最新进展已大幅降低了培养阴性感染的发生率，但其报告发病率仍然不可忽视。总体而言，已经开发了几种基于培养和非培养的方法来优化诊断，这主要依赖于术前和术中（即移除的植入物和周围组织）样本。本综述概述了用于诊断植入物相关感染病原体的主要基于培养和非培养的方法，并概述了它们在临床实践中的应用。此外，还描述了每种方法的优缺点。
