原生膝关节感染的微生物谱、术中发现和术后结果:回顾性分析。

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL
Jonas Roos, Britta Mangels, Max Jaenisch, Matthias Dominik Wimmer, Thomas Martin Randau, Christian Prangenberg, Kristian Welle, Martin Gathen
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引用次数: 0

摘要

背景:膝关节感染虽然不常见,但主要是由金黄色葡萄球菌等细菌引起的严重疾病。如果不及时干预,它们可能导致关节破坏或败血症,其风险因素包括先前存在的医疗条件和医源性手术。诊断过程包括全面的患者病史、临床评估、实验室检查、影像学检查和微生物学调查。治疗通常包括关节抽吸和关节镜检查。本研究旨在检验和建立诊断标准与治疗方式之间的相关性,以提高未来治疗策略的速度和特异性。材料和方法:本研究是一项回顾性队列研究,于2007年至2017年在一家拥有1200个床位的大学诊所进行,深入研究了患者的详细信息、症状、治疗和结果。我们开发了一个评分系统来对膝关节损伤的严重程度进行分类,根据住院时间、手术和术后因素(如复发症状、疼痛和活动范围)对患者进行分类。结果:116例膝关节感染患者的临床症状,如疼痛、肿胀和积液是常见的,但不是明确的诊断。实验室分析显示,在病原体阳性或阴性培养物之间,CRP或白细胞计数没有显著差异。住院时间和疾病严重程度受年龄、性别、是否存在多关节炎、中性粒细胞计数和病原体类型等因素的影响,体重和可的松治疗与预后较差相关。结论:本研究强调了先天性膝关节感染的诊断挑战,揭示了考虑到临床症状和实验室结果的非特异性,需要综合方法。这强调了通过标准化方法和前瞻性研究推进研究以提高该领域诊断准确性和治疗有效性的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Microbial Spectrum, Intraoperative Findings, and Postoperative Outcomes in Native Knee Joint Infections: A Retrospective Analysis.

Background: Native knee joint infections, while uncommon, present a serious condition predominantly instigated by bacteria such as Staphylococcus aureus. Without timely intervention, they can result in joint destruction or sepsis, with risk factors encompassing preexisting medical conditions and iatrogenic procedures. The diagnostic process includes a comprehensive patient history, clinical evaluation, laboratory testing, imaging studies, and microbiological investigations. Treatment typically involves joint aspiration and arthroscopy. This study aims to examine and establish correlations between diagnostic criteria and treatment modalities, enhancing the speed and specificity of future therapeutic strategies. Materials and methods: The present study is a retrospective cohort study conducted at a 1200-bed university clinic between 2007 and 2017, with an in-depth examination of patient details, symptoms, treatments, and outcomes. A scoring system was developed to classify the severity of knee joint impairment, categorizing patients on the basis of hospital stay duration, surgeries, and postoperative factors such as recurring symptoms, pain, and range of motion. Results: This study of 116 patients with knee joint infections revealed that clinical symptoms such as pain, swelling, and effusion are common but not definitive for diagnosis. Laboratory analysis revealed no significant differences in CRP or leukocyte counts between cultures positive or negative for pathogens. Hospital stay and disease severity are influenced by factors such as age, sex, presence of polyarthritis, neutrophil count, and type of pathogen, with higher weight and cortisone treatment associated with poorer outcomes. Conclusions: This study highlights the diagnostic challenges in native knee joint infections, revealing the need for comprehensive approaches given the nonspecificity of clinical symptoms and laboratory findings. This underscores the importance of advancing research through standardized methodologies and prospective studies to increase the accuracy of diagnosis and the effectiveness of treatment in this field.

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来源期刊
Clinics and Practice
Clinics and Practice MEDICINE, GENERAL & INTERNAL-
CiteScore
2.60
自引率
4.30%
发文量
91
审稿时长
10 weeks
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