How reliable are cultures of specimens from superficial swabs compared with those of deep tissue in patients with diabetic foot ulcers?
How reliable are cultures of specimens from superficial swabs compared with those of deep tissue in patients with diabetic foot ulcers?
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DOI：
10.1016/j.jdiacomp.2012.03.015
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发表时间：
2012-05-01
影响因子：
3
通讯作者：
Lipsky, Benjamin A.
中科院分区：
文献类型：
--
作者：
Mutluoglu, Mesut;Uzun, Gunalp;Lipsky, Benjamin A.
目的：通过将浅表拭子 (SS) 培养物与同时获得的糖尿病足溃疡患者深层组织 (DT) 标本培养物进行比较，评估浅表拭子 (SS) 培养物的可靠性。方法：我们回顾了两年期间就诊于我们高压医学中心的患有足部溃疡的糖尿病患者的临床和微生物学数据。我们确定了至少一对同时收集的 SS 和 DT 样本进行培养的患者。结果：从 54 名符合条件的患者中总共获得了 89 对培养物，其中 33 名 (61.1%) 住院。 47 名患者（87.0%）有伤口感染，28 名患者（51.9%）在上个月内接受过抗生素治疗。总体而言，65（73%）对 SS 和 DT 具有相同的培养结果，但 11（16.9%）例培养物是无菌的；因此，78 对培养阳性中只有 54 对 (69.2%) 具有相同的结果。与 DT 相比，SS 培养物在 10 例 (11.2%) 中产生 >= 1 种额外微生物，在 8 例 (9.0%) 中漏掉至少一种微生物，在 6 例 (6.7%) 中完全不同。与 DT 培养结果相比，SS 培养的阳性预测值为 84.4%，阴性预测值为 44.0%，总体准确率为 73.0%。结论：在糖尿病足溃疡患者中，SS 培养标本的结果与 DT 获得的结果相关性并不好。这表明 SS 标本在指导抗菌治疗方面可能不如 DT 标本可靠。 (c) 2012 Elsevier Inc. 保留所有权利。
Purpose: To assess the reliability of cultures of superficial swabs (SS) by comparing them with cultures of concomitantly obtained deep tissue (DT) specimens in patients with diabetic foot ulcers.Methods: We reviewed clinical and microbiological data from patients with diabetes who presented during a two-year period to our hyperbaric medicine center with a foot ulcer. We identified patients who had at least one concomitantly collected SS and DT pair of specimens sent for culture.Results: A total of 89 culture pairs were available from 54 eligible patients, 33 (61.1%) of whom were hospitalized. Wounds were infected in 47 (87.0%) of the patients and 28 (51.9%) patients had received antibiotic therapy within the previous month. Overall, 65(73%) of the SS and DT pairs had identical culture results, but in 11(16.9%) cases the cultures were sterile; thus, only 54 (69.2%) of the 78 culture-positive pairs had identical results. Compared with DT, SS cultures yielded >= 1 extra organism in 10 (11.2%) cases, missed at least one organism in 8 (9.0%), and were completely different in 6 (6.7%). When compared to DT culture results, SS cultures had a positive predictive value of 84.4%, negative predictive value of 44.0%, and overall accuracy of 73.0%.Conclusions: In patients with diabetic foot ulcers, results of specimens for culture taken by SS did not correlate well with those obtained by DT. This suggests that SS specimens may be less reliable for guiding antimicrobial therapy than DT specimens. (c) 2012 Elsevier Inc. All rights reserved.