PDF(Pubmed)
Abstract：
UNASSIGNED: Accurate identification of the etiology of orthopedic infection is very important for correct and timely clinical management, but it has been poorly studied. In the current study we explored the association of multiple bacterial pathogens with orthopedic infection.
UNASSIGNED: Hospitalized orthopedic patients were enrolled in a rural hospital in Qingdao, China. Wound or exudate swab samples were collected and tested for twelve bacterial pathogens with both culture and multiplex real time PCR.
UNASSIGNED: A total of 349 hospitalized orthopedic patients were enrolled including 193 cases presenting infection manifestations upon admission and 156 with no sign of infection. Orthopedic infection patients were mainly male (72.5%) with more lengthy hospital stay (median 15 days). At least one pathogen was detected in 42.5% (82/193) of patients with infection while 7.1% (11/156) in the patients without infection (P < 0.001). S. aureus was the most prevalent causative pathogen (15.5%). Quantity dependent pathogen association with infection was observed, particularly for P. aeruginosa and K. pneumoniae, possibly indicating subclinical infection. Most of the patients with detected pathogens had a previous history of orthopedic surgery (odds ratio 2.8, P = 0.038). Pathogen specific clinical manifestations were characterized. Multiplex qPCR, because of its high sensitivity, superior specificity, and powerful quantification could be utilized in combination with culture to guide antimicrobial therapy and track the progression of orthopedic infection during treatment.
UNASSIGNED: Hospitalized orthopedic patients were enrolled in a rural hospital in Qingdao, China. Wound or exudate swab samples were collected and tested for twelve bacterial pathogens with both culture and multiplex real time PCR.
UNASSIGNED: A total of 349 hospitalized orthopedic patients were enrolled including 193 cases presenting infection manifestations upon admission and 156 with no sign of infection. Orthopedic infection patients were mainly male (72.5%) with more lengthy hospital stay (median 15 days). At least one pathogen was detected in 42.5% (82/193) of patients with infection while 7.1% (11/156) in the patients without infection (P < 0.001). S. aureus was the most prevalent causative pathogen (15.5%). Quantity dependent pathogen association with infection was observed, particularly for P. aeruginosa and K. pneumoniae, possibly indicating subclinical infection. Most of the patients with detected pathogens had a previous history of orthopedic surgery (odds ratio 2.8, P = 0.038). Pathogen specific clinical manifestations were characterized. Multiplex qPCR, because of its high sensitivity, superior specificity, and powerful quantification could be utilized in combination with culture to guide antimicrobial therapy and track the progression of orthopedic infection during treatment.
摘要：
■准确识别骨科感染的病因对于正确及时的临床管理非常重要，但是研究很少。在当前的研究中，我们探索了多种细菌病原体与骨科感染的关联。
■住院的骨科患者在青岛的一家乡村医院登记，中国。收集伤口或渗出物拭子样品，并通过培养和多重实时PCR测试十二种细菌病原体。
■共纳入349例骨科住院患者，其中193例入院时出现感染表现，156例无感染迹象。骨科感染患者主要为男性（72.5%），住院时间较长（中位数为15天）。在42.5%(82/193)的感染患者中至少检测到一种病原体,在没有感染的患者中至少检测到一种病原体(P<0.001)。金黄色葡萄球菌是最常见的病原体(15.5%)。观察到数量依赖性病原体与感染的关联，特别是铜绿假单胞菌和肺炎克雷伯菌，可能提示亚临床感染.大多数检测到病原体的患者都有骨科手术史（比值比2.8，P=0.038）。有病原体特异性临床表现。多重qPCR，因为它的高灵敏度，优越的特异性，强大的定量可以与培养结合使用，以指导抗菌治疗并跟踪治疗期间骨科感染的进展。
■住院的骨科患者在青岛的一家乡村医院登记，中国。收集伤口或渗出物拭子样品，并通过培养和多重实时PCR测试十二种细菌病原体。
■共纳入349例骨科住院患者，其中193例入院时出现感染表现，156例无感染迹象。骨科感染患者主要为男性（72.5%），住院时间较长（中位数为15天）。在42.5%(82/193)的感染患者中至少检测到一种病原体,在没有感染的患者中至少检测到一种病原体(P<0.001)。金黄色葡萄球菌是最常见的病原体(15.5%)。观察到数量依赖性病原体与感染的关联，特别是铜绿假单胞菌和肺炎克雷伯菌，可能提示亚临床感染.大多数检测到病原体的患者都有骨科手术史（比值比2.8，P=0.038）。有病原体特异性临床表现。多重qPCR，因为它的高灵敏度，优越的特异性，强大的定量可以与培养结合使用，以指导抗菌治疗并跟踪治疗期间骨科感染的进展。
