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中华关节外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (06) : 827 -833. doi: 10.3877/cma.j.issn.1674-134X.2023.06.010

综述

细菌培养阴性的假体周围感染诊治的最新进展
李培杰, 乔永杰, 张浩强, 曾健康, 谭飞, 李嘉欢, 王静, 周胜虎()   
  1. 730030 兰州,甘肃中医药大学;730050 兰州,解放军联勤保障部队第九四〇医院关节外科
    730050 兰州,解放军联勤保障部队第九四〇医院关节外科
    730030 兰州,甘肃中医药大学
  • 收稿日期:2022-12-22 出版日期:2023-12-01
  • 通信作者: 周胜虎
  • 基金资助:
    甘肃省重点研发计划(21YF5FA154); 甘肃省青年科技基金(20JR5RA588); 甘肃省青年科技基金(21JR7RA014); 部队专项培育项目(2021YXKY014)

Progress in diagnosis and treatment of periprosthetic infection with negative bacterial culture

Peijie Li, Yongjie Qiao, Haoqiang Zhang, Jiankang Zeng, Fei Tan, Jiahuan Li, Jing Wang, Shenghu Zhou()   

  1. Gansu University of Traditional Chinese Medicine, Lanzhou 730030, China; No. 940 Hospital of the Joint Logistics Support Force of the Chinese people's Liberation Army, Lanzhou 730050, China
    No. 940 Hospital of the Joint Logistics Support Force of the Chinese people's Liberation Army, Lanzhou 730050, China
    Gansu University of Traditional Chinese Medicine, Lanzhou 730030, China
  • Received:2022-12-22 Published:2023-12-01
  • Corresponding author: Shenghu Zhou
引用本文:

李培杰, 乔永杰, 张浩强, 曾健康, 谭飞, 李嘉欢, 王静, 周胜虎. 细菌培养阴性的假体周围感染诊治的最新进展[J/OL]. 中华关节外科杂志(电子版), 2023, 17(06): 827-833.

Peijie Li, Yongjie Qiao, Haoqiang Zhang, Jiankang Zeng, Fei Tan, Jiahuan Li, Jing Wang, Shenghu Zhou. Progress in diagnosis and treatment of periprosthetic infection with negative bacterial culture[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(06): 827-833.

假体周围感染(PJI)是人工关节置换术后最严重的并发症之一。尽管医学领域已经做出了广泛的努力来提高细菌的阳性培养率,但假阴性率的培养结果仍然较高。在缺乏特定微生物的情况下,PJI的正确诊断、手术方式的选择以及抗生素的使用都将面临重大的挑战。因此,提高PJI的阳性培养率显得尤其重要。在这篇综述中,就近年来关于PJI诊治的文章进行简要分析,以期提高临床上培养阴性的PJI的诊治率。

Periprosthetic joint infection (PJI) is one of the most serious complications after artificial joint replacement. Although extensive efforts have been made in the medical field to increase positive culture rates of bacteria, culture results for false negative rates are still high. In the absence of specific microorganisms, the correct diagnosis of PJI, the choice of surgical modality, and the use of antibiotics will present significant challenges. Therefore, it is particularly important to increase the positive culture rate of PJI. In this review, a brief analysis of recent articles on the diagnosis and treatment of PJI was carried out in order to improve the diagnosis and treatment rate of clinically negative PJI.

表1 分子方法特点比较
Table 1 Comparison of molecular methods
[1]
Izakovicova P, Borens O, Trampuz A. Periprosthetic joint infection: current concepts and outlook[J]. EFORT Open Rev, 2019, 4(7): 482-494.
[2]
Kurtz SM, Lau EC, Son MS, et al. Are we winning or losing the battle with periprosthetic joint infection: trends in periprosthetic joint infection and mortality risk for the medicare population[J]. J Arthroplasty, 2018, 33(10): 3238-3245.
[3]
Wildeman P, Rolfson O, Söderquist B, et al. What are the long-term outcomes of mortality, quality of life, and hip function after prosthetic joint infection of the hip? A 10-year follow-up from Sweden[J]. Clin Orthop Relat Res, 2021, 479(10): 2203-2213.
[4]
Premkumar A, Kolin DA, Farley KX, et al. Projected economic burden of periprosthetic joint infection of the hip and knee in the United States[J]. J Arthroplasty, 2021, 36(5): 1484-1489.e3.
[5]
Goswami K, Parvizi J. Culture-negative periprosthetic joint infection: is there a diagnostic role for next-generation sequencing?[J]. Expert Rev Mol Diagn, 2020, 20(3): 269-272.
[6]
Della Valle C, Parvizi J, Bauer TW, et al. American Academy of Orthopaedic Surgeons clinical practice guideline on: the diagnosis of periprosthetic joint infections of the hip and knee[J]. J Bone Joint Surg Am, 2011, 93(14): 1355-1357.
[7]
Osmon DR, Berbari EF, Berendt AR, et al. Diagnosis and management of prosthetic joint infection: clinical practice guidelines by the Infectious Diseases Society of America[J/OL]. Clin Infect Dis, 2013, 56(1): e1-e25. DOI: 10.1093/cid/cis803.
[8]
Tirumala V, Smith E, Box H, et al. Outcome of debridement, antibiotics, and implant retention with modular component exchange in acute culture-negative periprosthetic joint infections[J]. J Arthroplasty, 2021, 36(3): 1087-1093.
[9]
Kang JS, Shin EH, Roh TH, et al. Long-term clinical outcome of two-stage revision surgery for infected hip arthroplasty using cement spacer: culture negative versus culture positive[J/OL]. J Orthop Surg, 2018, 26(1): 2309499017754095. DOI: 10.1177/2309499017754095.
[10]
何金,袁雪凌,陈歌. 细菌培养结果对髋假体周围感染翻修结果的影响[J]. 中国矫形外科杂志2020, 28(23): 2127-2130.
[11]
张泽宇,王启金,白国昌,等. 假体周围感染翻修术前预防性应用抗生素对术中标本培养阳性率的影响研究[J]. 中华创伤骨科杂志2021(5): 395-400.
[12]
Visperas A, Santana D, Klika AK, et al. Current treatments for biofilm-associated periprosthetic joint infection and new potential strategies[J]. J Orthop Res, 2022, 40(7): 1477-1491.
[13]
Mori Y, Nakagami G, Kitamura A, et al. Effectiveness of biofilm-based wound care system on wound healing in chronic wounds[J]. Wound Repair Regen, 2019, 27(5): 540-547.
[14]
Morgenstern C, Cabric S, Perka C, et al. Synovial fluid multiplex PCR is superior to culture for detection of low-virulent pathogens causing periprosthetic joint infection[J]. Diagn Microbiol Infect Dis, 2018, 90(2): 115-119.
[15]
Ascione T, Barrack R, Benito N, et al. General assembly, diagnosis, pathogen isolation - culture matters: proceedings of international consensus on orthopedic infections[J]. J Arthroplasty, 2019, 34(2S): S197-S206.
[16]
Abdel MP, Akgün D, Akin G, et al. Hip and knee section, diagnosis, pathogen isolation, culture: proceedings of international consensus on orthopedic infections[J]. J Arthroplasty, 2019, 34(2S): S361-S367.
[17]
Anemüller R, Belden K, Brause B, et al. Hip and knee section, treatment, antimicrobials: proceedings of international consensus on orthopedic infections[J]. J Arthroplasty, 2019, 34(2S): S463-S475.
[18]
Li C, Ojeda-Thies C, Xu C, et al. Meta-analysis in periprosthetic joint infection: a global bibliometric analysis[J/OL]. J Orthop Surg Res, 2020, 15(1): 251. DOI: 10.1186/s13018-020-01757-9.
[19]
Pitt WG, Ross SA. Ultrasound increases the rate of bacterial cell growth[J]. Biotechnol Prog, 2003, 19(3): 1038-1044.
[20]
刘侃,陈继营,郝立波. 超声裂解液培养在关节假体周围感染诊断中的应用[J]. 山东医药2021, 61(31): 9-12.
[21]
Kim HJ, Kim S, Mun JU, et al. Diagnosis of periprosthetic joint bacterial infections by culture of sonication fluid from infected implants[J/OL]. J Orthop Surg(Hong Kong), 2019, 27(1): 2309499019832417. DOI: 10.1177/2309499019832417.
[22]
Bürger J, Akgün D, Strube P, et al. Sonication of removed implants improves microbiological diagnosis of postoperative spinal infections[J]. Eur Spine J, 2019, 28(4): 768-774.
[23]
李程,Renz Nora, Trampuz Andrej. 超声裂解法在诊断假体周围感染的应用[J]. 实用骨科杂志2019, 25(8): 724-728.
[24]
黄子达,张翀景,李文波,等. 宏基因组二代测序技术检测病原菌在诊断假体周围感染中的作用[J]. 中华骨科杂志2019, 39(15): 944-953.
[25]
Chiu CY, Miller SA. Clinical metagenomics[J]. Nat Rev Genet, 2019, 20(6): 341-355.
[26]
Prinz J, Schmid B, Zbinden R, et al. Fast and sensitive multiplex real-time quantitative PCR to detect Cutibacteriumperiprosthetic joint infections[J]. J Mol Diagn, 2022, 24(6): 666-673.
[27]
Li C, Li H, Yang X, et al. Meta-analysis of synovial fluid polymerase chain reaction for diagnosing periprosthetic hip and knee infection[J/OL]. J Orthop Surg Res, 2022, 17(1): 3. DOI: 10.1186/s13018-021-02813-8.
[28]
Goswami K, Clarkson S, Phillips CD, et al. An enhanced understanding of culture-negative periprosthetic joint infection with next-generation sequencing: amulticenter study[J]. J Bone Joint Surg Am, 2022, 104(17): 1523-1529.
[29]
董伊隆,钱约男,李一民,等. 第二代测序技术用于全膝关节置换术后假体周围感染诊断的临床价值[J]. 浙江医学2021, 43(14): 1541-1544.
[30]
Tarabichi M, Shohat N, Goswami K, et al. Can next generation sequencing play a role in detecting pathogens in synovial fluid?[J]. Bone Joint J, 2018, 100-B(2): 127-133.
[31]
Aggarwal D, Kanitkar T, Narouz M, et al. Clinical utility and cost-effectiveness of bacterial 16S rRNA and targeted PCR based diagnostic testing in a UK microbiology laboratory network[J/OL]. Sci Rep, 2020, 10(1): 7965. DOI: 10.1038/s41598-020-64739-1.
[32]
Chen MF, Chang CH, Chiang-Ni C, et al. Rapid analysis of bacterial composition in prosthetic joint infection by 16S rRNA metagenomic sequencing[J]. Bone Joint Res, 2019, 8(8):367-377.
[33]
Hong HL, Flurin L, Thoendel MJ, et al. Targeted versus shotgun metagenomic sequencing-based detection of microorganisms in sonicate fluid for periprosthetic joint infection diagnosis[J/OL]. Clin Infect Dis, 2023, 76(3): e1456-e1462. DOI: 10.1093/cid/ciac646.
[34]
董文超,昝强,马建兵,等. 宏基因组二代测序技术在假体周围感染中寻找病原菌的应用和价值[J]. 实用骨科杂志2022, 28(1): 30-35.
[35]
Wang C, Huang Z, Li W, et al. Can metagenomic next-generation sequencing identify the pathogens responsible for culture-negative prosthetic joint infection?[J]. BMC Infect Dis, 2020, 20(1): 253. DOI: 10.1186/s12879-020-04955-2.
[36]
Dulanto Chiang A, Dekker JP. From the pipeline to the bedside: advances and challenges in clinical metagenomics[J]. J Infect Dis, 2020, 221(Suppl 3): S331-S340.
[37]
Tan TL, Kheir MM, Shohat N, et al. Culture-negative periprosthetic joint infection: an update on what to expect[J/OL]. JBJS Open Access, 2018, 3(3): e0060. DOI: 10.2106/JBJS.OA.17.00060.
[38]
Mulpur P, Sankineani SR, Thayi C, et al. Does early debridement, antibiotic therapy and implant retention (DAIR) have a role in managing periprosthetic joint infection of the knee in Indian scenario: aretrospective analysis of outcomes[J]. Indian J Orthop, 2021, 55(4): 961-966.
[39]
Soundarrajan D, Rajkumar N, Dhanasekararaja P, et al. A comparison of outcomes of culture positive and culture negative acute knee prosthetic joint infection following debridement, antibiotics and implant retention (DAIR)[J]. Eur J Orthop Surg Traumatol, 2023, 33(6): 2375-2383.
[40]
周胜虎,李峰,程永刚,等. 清创保留假体联合抗生素治疗膝关节置换术后急性感染[J/CD]. 中华关节外科杂志(电子版), 202216(4): 497-501.
[41]
Fokkema AT, Kampschreur LM, Pirii LE, et al. Rat bite fever in a total knee arthroplasty: an unusual case of periprosthetic joint infection[J/OL]. Arthroplasty, 2022, 4(1): 13. DOI: 10.1186/s42836-022-00114-x.
[42]
van Eck J, Liu WY, Goosen JHM, et al. Higher 1-year risk of implant removal for culture-positive than for culture-negative DAIR patients following 359 primary hip or knee arthroplasties[J]. J Bone Jt Infect, 2022, 7(4): 143-149.
[43]
Cuckler JM. The infected total knee: management options[J]. J Arthroplasty, 2005, 20(4 Suppl 2): 33-36.
[44]
Ibrahim MS, Twaij H, Haddad FS. Two-stage revision for the culture-negative infected total hip arthroplasty: a comparative study[J]. Bone Joint J, 2018, 100-B(1 Supple A): 3-8.
[45]
Yang J, Parvizi J, Hansen EN, et al. 2020 Mark Coventry Award: Microorganism-directed oral antibiotics reduce the rate of failure due to further infection after two-stage revision hip or knee arthroplasty for chronic infection: a multicentre randomized controlled trial at a minimum of two years[J]. Bone Joint J, 2020, 102-B(6_Supple_A): 3-9.
[46]
王华溢,杨重飞,陈永锋,等. 二期翻修治疗培养阴性膝关节假体周围感染[J/CD]. 中华关节外科杂志(电子版), 2021, 15(6): 680-686.
[47]
van den Kieboom J, Tirumala V, Box H, et al. One-stage revision is as effective as two-stage revision for chronic culture-negative periprosthetic joint infection after total hip and knee arthroplasty[J]. Bone Joint J, 2021, 103-B(3): 515-521.
[48]
Pangaud C, Ollivier M, Argenson JN. Outcome of single-stage versus two-stage exchange for revision knee arthroplasty for chronic periprosthetic infection[J]. EFORT Open Rev, 2019, 4(8):495-502.
[49]
Kunutsor SK, Whitehouse MR, Blom AW, et al. One- and two-stage surgical revision of peri-prosthetic joint infection of the hip: a pooled individual participant data analysis of 44 cohort studies[J]. Eur J Epidemiol, 2018, 33(10): 933-946.
[50]
Ji B, Li G, Zhang X, et al. Effective treatment of single-stage revision using intra-articular antibiotic infusion for culture-negative prosthetic joint infection[J]. Bone Joint J, 2020, 102-B(3): 336-344.
[51]
Hersh BL, Shah NB, Rothenberger SD, et al. Do culture negative periprosthetic joint infections remain culture negative?[J]. J Arthroplasty, 2019, 34(11): 2757-2762.
[52]
Saeed K, McLaren AC, Schwarz EM, et al. 2018 international consensus meeting on musculoskeletal infection: summary from the biofilm workgroup and consensus on biofilm related musculoskeletal infections[J]. J Orthop Res, 2019, 37(5): 1007-1017.
[53]
Xu Z, Huang C, Lin Y, et al. Clinical outcomes of culture-negative and culture-positive periprosthetic joint infection: similar success rate, different incidence of complications[J]. Orthop Surg, 2022, 14(7): 1420-1427.
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