Gotuzzo E, Carrillo C, Guerra J, Llosa L
J Infect Dis. 1986 Jan;153(1):122-5. doi: 10.1093/infdis/153.1.122.
Fifty patients, eventually diagnosed as having brucellosis, were studied prospectively for comparison of a simple culture of bone marrow aspirate from the iliac crest (0.5-1.0 ml) with two cultures of blood (5-10 ml) taken 30-60 min apart and with a tube-agglutination test. Cultures of bone marrow and blood were positive in 92% and 70% of the patients, respectively (P less than .001). Bacteria multiplied significantly faster in bone marrow cultures (4.32 vs. 6.65 days; P less than .001). All isolates were identified as Brucella melitensis biotype 1. Serological diagnosis was established in 86% of the patients. The efficacy of cultures of blood decreased significantly with chronic and subacute forms of infection, whereas that of bone marrow culture decreased only in chronic forms. Prior use of antibiotics reduced the positivity of cultures of blood but did not affect bone marrow culture. Bone marrow culture is recommended for patients with fever of unknown origin, negative serology, and unexplained articular or hematologic involvement, and patients in whom brucellosis is suspected.
对最终确诊为布鲁氏菌病的50例患者进行了前瞻性研究，以比较从髂嵴抽取的骨髓（0.5 - 1.0毫升）简单培养物与两份间隔30 - 60分钟采集的血液（5 - 10毫升）培养物以及试管凝集试验的效果。骨髓培养和血液培养的阳性率分别为92%和70%（P < 0.001）。细菌在骨髓培养物中的繁殖速度明显更快（4.32天对6.65天；P < 0.001）。所有分离株均鉴定为羊种布鲁氏菌生物型1。86%的患者建立了血清学诊断。血液培养的有效性在慢性和亚急性感染形式下显著降低，而骨髓培养仅在慢性形式下降低。先前使用抗生素降低了血液培养的阳性率，但不影响骨髓培养。对于不明原因发热、血清学阴性、不明原因关节或血液系统受累以及疑似布鲁氏菌病的患者，建议进行骨髓培养。
