已建立的测试方法的性能,用于诊断由低毒性病原体引起的慢性周围假肢关节感染
Markus Luger1, Lukas Rabitsch1, Martin McNally2
1Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
Bone & joint research
|December 8, 2025
概括
从低毒性病原体诊断出慢性周围假肢关节感染 (PJIs) 是一个挑战. 交尾液分析,特别是多态核核中性粒细胞 (SF-%PMN) 的百分比,提供了高准确度,有助于区分感染与无菌失败.
科学领域:
- 整形外科手术 整形外科手术
- 传染病 传染病 传染病
- 诊断病理学的诊断病理学
背景情况:
- 由低毒性病原体引起的慢性周围假肢关节感染 (PJIs) 难以区分于无菌松动.
- 准确的诊断对于有效的治疗和患者在修复关节整形术中的结果至关重要.
研究的目的:
- 评估常见测试的诊断准确性,以识别由低毒性病原体引起的慢性PJI.
- 将已确定的诊断值与新计算的切断值的性能进行比较.
主要方法:
- 分析了420名接受修复部或膝盖关节整形手术的患者.
- 病原体的分类为低毒性 (例如,凝结酶阴性葡萄球菌,Cutibacterium spp.,真菌) 和其他.
- 使用接收器操作特征 (ROC) 曲线评估突液参数 (SF-%PMN,SF-WBC) 和手术内组织学切口.
主要成果:
- >67%的多态核中性粒细胞 (SF-%PMN) 切断点的突液百分比显示出高的手术前诊断性能 (AUC 0.972).
- 同胞液白细胞计数 (SF-WBC) >2,403细胞/μl也显示出强大的诊断准确性 (AUC 0.927).
- 在手术过程中,永久性固定段 (AUC 0.946) 和冷段 (AUC 0.922) 呈现出极好的准确性.
结论:
- SF-%PMN和SF-WBC,以及永久组织学截图,在诊断由低毒性病原体引起的PJIs方面非常有效.
- 术前冷切口是一种有价值的工具,特别是当手术前诊断不确定时.
- 考虑较低的SF-%PMN切线 (>67%) 可能会改善这些具有挑战性的感染的诊断.
相关概念视频
01:30Pneumonia III: Complications and Assessment
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
01:25Rapid Identification of Pathogens
MALDI-TOF MS has transformed clinical microbiology by offering a rapid and reliable method for pathogen identification. The traditional approach to microbial identification typically involves time-consuming culture techniques and biochemical tests, which can delay the initiation of appropriate antimicrobial therapy. MALDI-TOF MS avoids these delays by using characteristic ribosomal protein mass patterns of microbial cells, enabling accurate species-level identification within minutes.Principle...
01:24Automated Microbial Diagnostics
Automated diagnostic analyzers have transformed clinical microbiology by providing rapid and reliable methods for pathogen identification and antibiotic susceptibility testing. Among these systems, the Vitek 2 is widely used because it automates the traditionally labor-intensive processes of microbial identification (ID) and antibiotic susceptibility testing (AST), delivering standardized and timely results that are essential for effective patient care.Microbial Identification with ID CardsThe...