在怀疑关节感染时,基因染色关节吸血剂的准确性和诊断价值
James Zhang1,2,3, Anna Stevenson1,2, Andrew Kailin Zhou2
1Clinical School of Medicine, University of Cambridge, Cambridge, England, UK.
概括
败血性关节炎的初始格拉姆染色具有低灵敏度 (30.4%),需要谨慎使用负面结果. 假肢关节和抗生素使用等因素增加了感染风险和虚假阴性结果.
科学领域:
- 整形外科 整形外科 整形外科
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 败血性关节炎是一种严重的关节感染,需要及时诊断和治疗.
- 关节液的格拉姆染色是一种常见的初始诊断测试.
- 准确及时诊断对于预防关节损伤和全身并发症至关重要.
研究的目的:
- 为了评估疑似败血性关节炎的格拉姆染色的诊断准确性.
- 识别与阳性细菌培养相关的因素.
- 为了探索错误阴性格拉姆染色结果导致败血性关节炎的预测因素.
主要方法:
- 在一个主要的创伤中心,从2015年到2021年对408个关节志愿者的回顾性审查.
- 对格拉姆染料敏感度,特异性和结果的时间进行分析.
- 后勤回归用于识别与阳性培养和假阴性格拉姆染色相关的因素.
主要成果:
- 克拉姆染色剂的灵敏度为30.4%,特异性为97.6%.
- 延迟时间为1.1天的格拉姆染色和5.4天的培养.
- 假肢关节,以前的感染,关节炎,高血压和糖尿病与积极的文化有关. 以前的感染和抗生素使用增加了假阴性格拉姆染色的风险.
结论:
- 格拉姆染色的低灵敏度需要仔细解释疑似败血性关节炎的负面结果.
- 对于患有并发症或抗生素使用等危险因素的患者,临床警至关重要.
- 当格拉姆染色结果阴性但临床怀疑仍然很高时,进一步的诊断步骤至关重要.
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