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首页> 外文期刊>Journal of Clinical Microbiology >How Many Samples and How Many Culture Media To Diagnose a Prosthetic Joint Infection: a Clinical and Microbiological Prospective Multicenter Study
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How Many Samples and How Many Culture Media To Diagnose a Prosthetic Joint Infection: a Clinical and Microbiological Prospective Multicenter Study

机译：有多少样本和多少种培养基可诊断人工关节感染：临床和微生物学前瞻性多中心研究

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Although numerous perioperative samples and culture media are required to diagnose prosthetic joint infection (PJI), their exact number and types have not yet been definitely determined with a high level of proof. We conducted a prospective multicenter study to determine the minimal number of samples and culture media required for accurate diagnosis of PJI. Over a 2-year period, consecutive patients with clinical signs suggesting PJI were included, with five perioperative samples per patient. The bacteriological and PJI diagnosis criteria were assessed using a random selection of two, three, or four samples and compared with those obtained using the recommended five samples (references guidelines). The results obtained with two or three culture media were then compared with those obtained with five culture media for both criteria. The times-to-positivity of the different culture media were calculated. PJI was confirmed in 215/264 suspected cases, with a bacteriological criterion in 192 (89%). The PJI was monomicrobial (85%) or polymicrobial (15%). Percentages of agreement of 98.1% and 99.7%, respectively, for the bacteriological criterion and confirmed PJI diagnosis were obtained when four perioperative samples were considered. The highest percentages of agreement were obtained with the association of three culture media, a blood culture bottle, a chocolate agar plate, and Schaedler broth, incubated for 5, 7, and 14 days, respectively. This new procedure leads to significant cost saving. Our prospective multicenter study showed that four samples seeded on three culture media are sufficient for diagnosing PJI.
机译：尽管需要大量围手术期的样品和培养基来诊断假体关节感染（PJI），但尚未明确确定其确切的数量和类型，并具有高水平的证据。我们进行了一项前瞻性多中心研究，以确定准确诊断PJI所需的最少样品和培养基。在2年的时间里，包括具有PJI临床症状的连续患者，每例患者围手术期采集5个样本。使用两个，三个或四个样本的随机选择评估细菌学和PJI诊断标准，并将其与使用推荐的五个样本获得的标准进行比较（参考指南）。然后将两种或三种培养基获得的结果与两种标准中五种培养基获得的结果进行比较。计算了不同培养基的阳性反应时间。在215/264例疑似病例中确诊为PJI，192例（89％）符合细菌学标准。 PJI为单微生物（85％）或多微生物（15％）。当考虑四个围手术期样本时，细菌学标准和确诊的PJI诊断的一致性百分比分别为98.1％和99.7％。三种培养基（血液培养瓶，巧克力琼脂平板和Schaedler肉汤）分别孵育5天，7天和14天，可以达到最高的一致性。此新程序可节省大量成本。我们的前瞻性多中心研究表明，在三种培养基上播种的四个样本足以诊断PJI。

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