Cui Yunpeng, Wang Qiwei, Mi Chuan, Wang Bing, Pan Yuanxing, Lin Yunfei, He Rui, Sun Liying, Zheng Bo, Shi Xuedong
Department of Orthopaedics, Peking University First Hospital, Beijing, People's Republic of China.
Department of Plastic Surgery and Burn, Peking University First Hospital, Beijing, People's Republic of China.
Infect Drug Resist. 2024 Jul 22;17:3173-3183. doi: 10.2147/IDR.S464350. eCollection 2024.
This retrospective cohort study explores a practical approach to acquiring pathogenic microorganisms in patients with bone and joint infections.
From Aug 2018 to Mar 2022, 68 consecutive patients (87 cultures) with bone and joint infection were recruited in this study. All cultures followed the Peking University First Hospital Procedure of Culturing Pathogenic microorganisms for bone and joint infection. Tissue samples were obtained through fluoroscopy-guided biopsy or open debridement. Tissue samples were divided into manual homogenization (MH), manual mixture (MM), and pathological examination. The baseline, antibiotic exposure, laboratory, surgical, and microbial data were reviewed. Independent sample -test, Mann-Whitney -test, and Chi-square test were used to detect the difference between patients who received different processing measures.
The average age was 55.8±2.4 years old. Thirty-nine patients were male. The total positive culture rate of the manual homogenization group was 80.5% (70/87). Thirty-five patients had mixed infections with more than one microorganism cultured. Staphylococci accounted for 60.23% of all microorganisms. Staphylococcus aureus (18.2%) and Staphylococcus epidermidis (15.9%) were the two most common bacteria cultured in this study. Patients with positive culture in the manual mixture group had significantly higher WBC (p = 0.006), NE% (p = 0.024), ESR (p = 0.003), CRP (p = 0.020) and IL6 (0.050) compared to patients with negative culture. After tissue homogenization, only ESR is still statistically different. Patients without SIRS had a low positive culture rate (59.4%). Tissue homogenization could significantly increase the positive culture rate of patients without SIRS. Pre-culture antibiotic exposure was not an independent risk factor for culture results.
Peking University First Hospital Procedure for Culturing Pathogenic microorganisms for Bone and Joint Infections was a practical approach for obtaining pathogenic microorganisms.
这项回顾性队列研究探索了一种获取骨与关节感染患者致病微生物的实用方法。
2018年8月至2022年3月，本研究纳入了68例连续的骨与关节感染患者（87份培养样本）。所有培养均遵循北京大学第一医院骨与关节感染致病微生物培养程序。通过透视引导下活检或开放清创获取组织样本。组织样本分为手工匀浆（MH）、手工混合（MM）和病理检查。回顾了基线、抗生素暴露、实验室、手术和微生物数据。采用独立样本t检验、曼-惠特尼U检验和卡方检验来检测接受不同处理措施的患者之间的差异。
平均年龄为55.8±2.4岁。39例为男性。手工匀浆组的总培养阳性率为80.5%（70/87）。35例患者存在多种微生物混合感染。葡萄球菌占所有微生物的60.23%。金黄色葡萄球菌（18.2%）和表皮葡萄球菌（15.9%）是本研究中培养出的两种最常见细菌。与培养阴性的患者相比，手工混合组培养阳性的患者白细胞（WBC）（p = 0.006）、中性粒细胞百分比（NE%）（p = 0.024）、红细胞沉降率（ESR）（p = = 0.003）、C反应蛋白（CRP）（p = 0.020）和白细胞介素6（IL6）（0.050）显著更高。组织匀浆后，只有ESR仍有统计学差异。无全身炎症反应综合征（SIRS）的患者培养阳性率较低（59.4%）。组织匀浆可显著提高无SIRS患者的培养阳性率。培养前的抗生素暴露不是培养结果的独立危险因素。
北京大学第一医院骨与关节感染致病微生物培养程序是获取致病微生物的一种实用方法。
