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用于隆鼻术后鼻腔感染细菌鉴定的假体细菌培养

Prosthetic bacterial culture for bacterial identification of nasal infections after rhinoplasty.

作者信息

Zeng Qi, Tang Yu-Xi, Yu Bao-Fu

机构信息

Department of Plastic Surgery, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, 152 Ai Guo Road, Nanchang, 330006, Jiangxi, China.

Department of Plastic and Aesthetic Surgery, Shanghai BeauCare Clinic, Shanghai, China.

出版信息

Sci Rep. 2025 May 13;15(1):16572. doi: 10.1038/s41598-025-01377-5.

Abstract

Infection following rhino-prosthesis surgery poses a significant challenge, with primary treatment strategies centered on identifying specific pathogenic bacteria through bacterial culture and administering effective antibiotics. This study aimed to investigate whether conducting bacterial cultures that specifically target the nasal prosthesis could provide more objective guidance for clinical decision-making. We included patients who developed infections subsequent to prosthesis rhinoplasty in this investigation. The clinical significance of bacterial cultures obtained from nasal prostheses was assessed by comparing the culture results with those derived from the nasal mucosa or secretions from disrupted wounds. Notably, the bacterial detection rate in samples taken from prosthetic devices was significantly higher than that observed in conventional specimens from the same patients, exhibiting a statistically significant difference. Within the prosthetic group, no statistically significant difference was identified in bacterial detection rates between patients who received antibiotics 3 days prior to surgery and those who did not. In contrast, in the conventional control group, there was a marked decrease in bacterial detection rates among patients following antibiotic administration. Among patients treated with antibiotics, the detection rate of bacteria cultured from prosthetic specimens was significantly higher compared to that in the control group; however, there were no statistical differences found regarding bacterial detection rates for those not treated with antibiotics. In analyzing materials within the prosthesis group: silicone implants showed a bacterial detection rate of 80%, expanded polytetrafluoroethylene materials had a rate of 79.2%, and other materials demonstrated a 90.9%rate. No statistically significant differences were noted among these three material types within this cohort. In contrast, within the control group: silicone implants exhibited a bacterial detection rate of 66.7%, expanded polytetrafluoroethylene materials registered at 73.6%, while other materials maintained a lower count at 63.6%. Similarly, no statistically significant differences prevailed among these groups. Culturing prosthetic specimens can enhance the detection rate of bacteria, particularly in patients who have received antibiotic therapy prior to surgery, offering distinct advantages. Therefore, we advocate for the implementation of prosthetic specimen cultures as an adjunctive measure for detecting infections post-nasal prosthesis reconstruction. Among patients treated with antibiotics, the rate of bacteria detected from cultured prosthetic specimens was significantly higher compared to that in the control group. However, no statistically significant differences were observed regarding bacterial detection rates in patients not receiving antibiotic treatment. When analyzing materials within the prosthesis group: silicone implants exhibited a bacterial detection rate of 80%, expanded polytetrafluoroethylene (ePTFE) materials had a detection rate of 79.2%, and other materials demonstrated a higher rate of 90.9%. Notably, there were no statistically significant differences among these three material types within this cohort. In contrast, within the control group: silicone implants displayed a bacterial detection rate of 66.7%, ePTFE materials showed a rate of 73.6%, while other materials recorded a lower count at 63.6%. Similarly, no statistically significant differences emerged among these groups. Culturing prosthetic specimens can enhance the detection rates of bacteria, particularly in patients who have undergone antibiotic therapy prior to surgery, thereby offering distinct advantages for infection diagnosis. Therefore, we advocate for incorporating cultures of prosthetic specimens as an adjunctive measure for detecting infections following nasal prosthesis reconstruction.Level of evidence: Level 4.

摘要

鼻假体手术后的感染是一项重大挑战,主要治疗策略集中在通过细菌培养识别特定病原菌并使用有效的抗生素。本研究旨在探讨针对鼻假体进行细菌培养是否能为临床决策提供更客观的指导。我们纳入了在本次调查中鼻整形术后发生感染的患者。通过将从鼻假体获得的细菌培养结果与从鼻黏膜或伤口分泌物中获得的结果进行比较,评估从鼻假体获得的细菌培养的临床意义。值得注意的是,从假体装置采集的样本中的细菌检出率显著高于同一患者的常规标本,差异具有统计学意义。在假体组中,术前3天接受抗生素治疗的患者与未接受抗生素治疗的患者之间,细菌检出率没有统计学差异。相比之下,在传统对照组中,抗生素给药后患者的细菌检出率显著下降。在接受抗生素治疗的患者中,从假体标本培养出的细菌检出率显著高于对照组;然而,未接受抗生素治疗的患者在细菌检出率方面没有统计学差异。在分析假体组内的材料时:硅胶植入物的细菌检出率为80%,膨体聚四氟乙烯材料为79.2%,其他材料为90.9%。在该队列中,这三种材料类型之间没有统计学差异。相比之下,在对照组中:硅胶植入物的细菌检出率为66.7%,膨体聚四氟乙烯材料为73.6%,而其他材料较低,为63.6%。同样,这些组之间没有统计学差异。培养假体标本可以提高细菌检出率,特别是在术前接受过抗生素治疗的患者中,具有明显优势。因此,我们主张将假体标本培养作为鼻假体重建后感染检测的辅助措施。在接受抗生素治疗的患者中,从培养的假体标本中检测到细菌的比率显著高于对照组。然而,在未接受抗生素治疗的患者中,细菌检出率没有统计学差异。当分析假体组内的材料时:硅胶植入物的细菌检出率为80%,膨体聚四氟乙烯(ePTFE)材料的检出率为79.2%,其他材料的检出率较高,为90.9%。值得注意的是,在该队列中,这三种材料类型之间没有统计学差异。相比之下,在对照组中:硅胶植入物的细菌检出率为66.7%,ePTFE材料的检出率为73.6%,而其他材料的检出率较低,为63.6%。同样,这些组之间没有统计学差异。培养假体标本可以提高细菌检出率,特别是在术前接受过抗生素治疗的患者中,从而为感染诊断提供明显优势。因此,我们主张将假体标本培养作为鼻假体重建后感染检测的辅助措施。证据级别:4级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5e9/12075707/bc8514ae48c8/41598_2025_1377_Fig1_HTML.jpg

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