Detection limitations of bacteria in tissue samples.

IF 4.7 2区 医学 Q2 CELL & TISSUE ENGINEERING
Tim Holm Jakobsen, Julius Bier Kirkegaard, Mads Lichtenberg, Lasse Andersson Kvich, Hans Gottlieb, Martin McNally, Thomas Bjarnsholt
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引用次数: 0

Abstract

Aims: Successful identification of bacteria in tissue samples requires careful consideration of multiple factors, including sample type and quality, the type of bacteria being detected, and the sensitivity and specificity of the detection method. Here, we address the issues of detecting a small number of bacteria, often found in biofilms and heterogeneously distributed in a large volume (the surgical site with suspected infection). Specifically, the study seeks to address the difficulties in detecting small numbers of bacteria, and to evaluate the impact of bacterial aggregation on the probability of successful detection.

Methods: We present simple formulae for the probability of detecting bacteria in different infection scenarios where the number of bacteria and size of bacterial aggregates are incorporated as variables. We define a critical aggregation parameter, above which the probability of sampling bacteria decreases dramatically.

Results: Our calculations demonstrate that aggregation of bacteria in tissues can strongly impact the probability of detection, where an increase in aggregate size results in a reduced probability of obtaining a positive biopsy. Our calculations underscore the challenges in effectively sampling tissue for diagnostic purposes, particularly in low-grade infections characterized by small bacterial quantities within aggregates. Below the critical aggregation parameter, obtaining five tissue specimens is associated with a high probability of detecting infection, but at a higher aggregation level, increasing the number of specimens is rendered ineffective, resulting in culture-negative diagnoses.

Conclusion: We hypothesize that the high false-negative rate in diagnosing orthopaedic surgical site infections, such as periprosthetic joint infections, could be partly influenced by the heterogeneous bacterial distribution and the sampling complexities of such populations outlined here. Homogenization of tissue specimens is a technique to enhance the surface area which potentially could increase the detection of heterogeneously distributed bacteria.

组织样品中细菌的检测限制。
目的:组织样品中细菌的成功鉴定需要仔细考虑多种因素,包括样品类型和质量、被检测细菌的类型、检测方法的敏感性和特异性。在这里,我们解决了检测少量细菌的问题,这些细菌通常存在于生物膜中,并且在大体积(疑似感染的手术部位)中分布不均。具体而言,该研究旨在解决检测少量细菌的困难,并评估细菌聚集对成功检测概率的影响。方法:我们提出了一个简单的公式,在不同的感染情况下检测细菌的概率,其中细菌的数量和细菌聚集体的大小被纳入变量。我们定义了一个临界聚集参数,在此参数之上,采样细菌的概率急剧下降。结果:我们的计算表明,组织中细菌的聚集会强烈影响检测的概率,其中聚集大小的增加会导致获得阳性活检的概率降低。我们的计算强调了有效取样组织诊断目的的挑战,特别是在低级别感染的特点是小细菌数量聚集。在临界聚集参数以下,获得5个组织标本与检测感染的高概率相关,但在更高的聚集水平下,增加标本数量无效,导致培养阴性诊断。结论:我们假设骨科手术部位感染(如假体周围关节感染)诊断的高假阴性率可能部分受到异质细菌分布和采样复杂性的影响。组织标本的均质化是一种增加表面积的技术,这可能会增加对分布不均的细菌的检测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Bone & Joint Research
Bone & Joint Research CELL & TISSUE ENGINEERING-ORTHOPEDICS
CiteScore
7.40
自引率
23.90%
发文量
156
审稿时长
12 weeks
期刊介绍: The gold open access journal for the musculoskeletal sciences. Included in PubMed and available in PubMed Central.
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