Swab cultures accurately identify bacterial pathogens in diabetic foot wounds not involving bone
Swab cultures accurately identify bacterial pathogens in diabetic foot wounds not involving bone
复制标题
DOI：
10.1111/j.1464-5491.2004.01221.x
复制
发表时间：
2004-07-01
影响因子：
3.5
通讯作者：
Rapoport, MJ
中科院分区：
文献类型：
--
作者：
Slater, RA;Lazarovitch, T;Rapoport, MJ
AIM目前的临床实践假设伤口拭子培养是不可靠的。然而，这一假设是基于仅从存在骨髓炎和/或坏疽的伤口中挑选的数据。本研究旨在重新评估拭子培养和深层组织培养在不同深度和严重程度的糖尿病创面中的准确性。方法对60例糖尿病足感染创面进行培养。结果37个创面(62%)拭子标本与深部组织标本细菌培养结果一致。在另外12个创面(20%)，拭子培养含有所有从深层组织培养中分离出来的微生物，但也含有额外的微生物。根据伤口深度进行分析，表明拭子培养在36/40个未延伸到骨骼的伤口(90%)和13/20个延伸到骨骼的伤口(65%)的深层组织标本中分离到所有微生物。结论拭子培养在糖尿病足非骨骼伤口的病原体鉴定中有价值。当手术清创被禁忌或延迟时，可以用拭子培养来选择适当的抗生素治疗。
Aims Current clinical practice assumes swab cultures from wounds are unreliable. However, this assumption is based upon data culled only from wounds in which osteomyelitis and/or gangrene were present. This study aimed to re-evaluate the accuracy of swab cultures vs. deep tissue cultures in diabetic wounds of varying depth and severity.Methods A total of 60 infected diabetic foot wounds were cultured. Two specimens were taken from each wound: superficial swab before debridement and deep tissue specimen towards the end of surgical debridement.Results In 37 wounds (62%), the micro-organisms isolated from the swab specimen and those isolated from the deep tissue specimen were identical. In another 12 wounds (20%), the swab culture contained all micro-organisms isolated from the deep tissue culture, but also contained additional micro-organisms. Analysis according to the depth of the wound, demonstrated that swabs identified all micro-organisms isolated from the deep tissue specimens in 36/40 wounds (90%) that did not extend to bone as opposed to 13/20 wounds (65%) that extended to bone.Conclusions Swab cultures are valuable in identifying pathogens in diabetic foot wounds when bone is not involved. When surgical debridement is contraindicated or delayed, swab cultures can be used to select appropriate antibiotic therapy.