抗生素暴露时间对周围假肢关节感染病原体检测的影响
Lan Lin1,2,3, Wenkang You1,2,3, Yuntao Liao1,2,3
1Department of Orthopaedic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China.
Infection and drug resistance
|November 10, 2025
概括
抗生素暴露显著影响周围假肢关节感染 (PJI) 中的病原体检测. 甲基因组下一代测序 (mNGS) 与微生物培养相比,提供更高的诊断准确性,特别是在长时间使用抗生素后.
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:
- 周围假肢关节感染 (PJI) 的诊断严重依赖于微生物学分析.
- 以前接触过抗生素可以显著阻碍致病原体的准确识别.
- 优化诊断策略对于有效的PJI管理至关重要.
研究的目的:
- 评估在采样前抗生素持续时间对微生物培养和基因组下一代测序 (mNGS) 在PJI的诊断性能的影响.
- 在不同的抗生素暴露场景下,比较mNGS与常规培养的灵敏度和特异性.
主要方法:
- 对153名PJI患者的回顾性分析.
- 根据抗生素暴露的持续时间,将其分为抗生素禁用 (AWD),短期抗生素 (STA) 和长期抗生素 (LTA) 组.
- 微生物培养和mNGS结果在不同组之间的比较.
主要成果:
- 在STA (86.7%对70.0%) 和LTA (76.2%对54.8%) 组中,mNGS的阳性率高于微生物培养群.
- 长期使用抗生素 (>7天) 显著降低了培养阳性 (86.3%至54.8%),但对mNGS灵敏度的影响较小 (92.2%至76.2%).
- mNGS在所有组的培养阴性PJI病例中保持了强大的诊断性能.
结论:
- 在采样前使用抗生素会严重影响PJI病原体检测.
- 为了提高诊断准确度,请考虑在没有抗生素至少7天后取样.
- 在长期使用抗生素 (>7天) 的患者中,建议将微生物培养与常规mNGS结合起来.
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