在假肢关节感染的诊断实践的全球调查
Shradha Subedi1, Patrick Na Harris2, Paul Chapman3
1University of Queensland, UQ Centre for Clinical Research, Brisbane, Queensland, Australia; Sunshine Coast Hospital and Health Service, Queensland, Australia.
Diagnostic microbiology and infectious disease
|June 6, 2025
概括
诊断假肢关节感染 (PJI) 的全球实践有很大的差异. 这项调查突出了组织样本采集,培养化和鉴定方法的差异,影响了PJI诊断的准确性.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 整形外科手术 整形外科手术
背景情况:
- 假肢关节感染 (PJI) 带来了重大的临床和经济挑战.
- 准确的微生物学诊断对于有效的抗菌治疗PJIs至关重要.
- 目前的国际指导方针对PJI的最佳诊断实践提供了有限的清晰度.
研究的目的:
- 对假肢关节感染 (PJI) 的全球诊断实践进行调查和分析.
- 为了识别在不同的国际医疗保健环境中使用的微生物学方法的变化.
主要方法:
- 一项全球调查涉及24个国家的107家医院.
- 收集的数据包括周围假肢组织样本采集,超声波检测,培养化期,细菌鉴定 (MALDI-TOF),敏感性测试 (EUCAST) 和PCR可用性.
主要成果:
- 在收集的组织样本数量中观察到显著的变化 (49.5%收集了5-6个样本,11%收集了<3).
- 培养化期各不相同,42%使用≤5天,但70%在必要时延长化期.
- 矩阵辅助激光脱/离子化飞行时间 (MALDI-TOF) 被广泛用于识别 (74.8%),EUCAST用于敏感性测试 (64.5%),并指出了洲际差异. 聚合酶链反应 (PCR) 的可用性有限 (43%).
结论:
- 全球PJI诊断实践异质,影响微生物学结果的一致性.
- 样品处理,培养时间和鉴定方法的变化导致报告的PJI病因和培养负率的差异.
- 需要对诊断协议进行标准化,以提高全球PJI诊断的准确性和可比性.
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