Molinier S, Paris J F, Brisou P, Amah Y, Morand J J, Alla P, Carli P
Service de médecine interne, hôpital d'instruction des armées Sainte-Anne, Toulon Naval, France.
Rev Med Interne. 1998 Aug;19(8):568-70. doi: 10.1016/s0248-8663(99)80025-3.
The multiplication of invasive spine investigations for either diagnostic or therapeutical purposes increases the risk for iatrogenic infections. We report two cases of iatrogenic infections, one case of meningitidis and one case of spondylodiscitis due to Streptococcus viridans.
The two cases included a 42-year-old male patient presenting with spondylodiscitis due to Streptococcus oralis following nucleolysis for discal node and a 51-year-old female patient with purulent meningitidis due to Streptococcus salivarius following hysteroscopy with spinal anesthesia. According to the disease chronology and bacterial results, iatrogenesis was evidenced. The streptococci originate from the patient's skin or from the operators' endobuccal flora.
Simple aseptic rules, including wearing a surgical mask during any spinal tap, would definitely avoid iatrogenic infections.
出于诊断或治疗目的而进行的侵入性脊柱检查增多,增加了医源性感染的风险。我们报告两例医源性感染病例,一例为脑膜炎,另一例为草绿色链球菌引起的脊椎椎间盘炎。
这两例病例包括一名42岁男性患者,因椎间盘结节进行溶核术后发生口腔链球菌引起的脊椎椎间盘炎,以及一名51岁女性患者,在脊髓麻醉下行宫腔镜检查后发生唾液链球菌引起的化脓性脑膜炎。根据疾病发生时间顺序和细菌检测结果,证实了医源性感染。这些链球菌源自患者皮肤或术者口腔内菌群。
简单的无菌规则,包括在任何腰椎穿刺操作过程中佩戴外科口罩,肯定能避免医源性感染。