Mousa H A
Basrah University Teaching Hospital, Iraq.
J Bone Joint Surg Br. 1997 Jul;79(4):567-9. doi: 10.1302/0301-620x.79b4.7316.
Sinus-track cultures were compared prospectively with cultures from operative specimens in 55 patients with chronic bone infection. There was a total of 115 operative isolates; 102 of the sinus-track isolates were identical (88.7%), showing a specificity of 95.7% and a predictive value of 90.3%. A sinus-track specimen proved to be a reliable source for the isolation of all bacteria causing chronic bone infection except Staphylococcus epidermidis, provided that material from the depths of the sinus was aspirated by syringe from an active flowing sinus and inoculated immediately on culture media. Cotton-swab sinus specimens were unreliable for the isolation of mycobacteria, and could miss many pyogenic bacteria, or contain contaminants. Tuberculous bone infection should be suspected if there is no growth of any pyogenic bacteria or if there is growth of Staphyloccocus epidermidis alone on routine aerobic and anaerobic sinus cultures. Mycobacteria can often be identified from sinus-track culture from patients in whom operative culture, histopathology and clinical examination have failed to confirm the diagnosis of tuberculosis.
对55例慢性骨感染患者的窦道培养物与手术标本培养物进行了前瞻性比较。手术分离出的菌株共有115株；102株窦道分离株与之相同（88.7%），特异性为95.7%，预测值为90.3%。如果用注射器从活跃引流的窦道深处抽取材料并立即接种于培养基上，窦道标本被证明是分离除表皮葡萄球菌外所有引起慢性骨感染细菌的可靠来源。棉拭子窦道标本对于分枝杆菌的分离不可靠，可能会遗漏许多化脓性细菌，或含有污染物。如果常规需氧和厌氧窦道培养未发现任何化脓性细菌生长，或仅发现表皮葡萄球菌生长，则应怀疑结核性骨感染。对于手术培养、组织病理学和临床检查均未能确诊为结核的患者，通常可从窦道培养物中鉴定出分枝杆菌。
