慢性骨髓炎窦道分泌物与病灶组织的细菌学研究

Sinus Tract and Focus Tissue Cultures in Chronic Osteomyelitis:Comparison of Results

目的了解窦道病灶与分泌物的病原菌菌群间的区别,更好地指导临床应用抗菌药物。方法49例伴有窦道的慢性骨髓炎患者,分别于术前取窦道分泌物及术中取病灶组织做细菌培养,比较两种标本培养结果之间的差别。结果窦道分泌物的菌种数、菌种分布及前3位菌种检出率排序与病灶组织相近或相同;窦道分泌物检出菌株数显著多于病灶组织;两种标本培养结果完全相同的共有27例(55.0%)。结论两种标本的菌种数及菌种分布相似;窦道分泌物培养病原菌阳性结果约占50.0%,如果依据其培养结果选用良好的抗菌药物,其正确率约为67.3%。

OBJECTIVE To understand the difference between pathogenic bacteria in focus and microbial population in sinus tract discharge and guide preferably clinical application of antibiotics. METHODS Forty-nine patients who had chronic osteomyelitis with sinus tract were included in the study. In each patient, we obtained specimen of sinus tract discharge before operation and specimen of material in focus during operation for bacterial culture. The results of bacterial cultures of two specimens were compared. RESULTS ① Number, spectrum and the first three places of organisms of sinus tract discharge were similar or the same to that of material in focus. ② Number of strains isolated from sinus tract discharge was more than that from material in focus. ③Of forty-nine patients, the specimens from two sites had the same results of bacterial cultures（ including eight cases with germfree） in twenty-seven （55.0%）. In an additional six patients, the organisms isolated from sinus tract discharge included the organisms from material in focus. CONCLUSIONS ONumber and spectrum of organisms isolated from sinus track discharge are similar to that from material in focus. ②The results of bacterial cultures of sinus tract discharge represent the actual pathogenic bacteria in 50.0% of the patients. The accurate rate of selecting antibiotics depending on the results of bacterial cultures of sinus tract discharge is 67.3%.