亚甲蓝对关节假体周围感染细菌培养的影响△

Effect of methylene blue on bacterial culture in periprosthetic joint infection

摘要:

［目的］探讨染色剂亚甲蓝对关节假体周围感染组织样本细菌培养的影响。［方法］对 2017 年 10 月—2019 年 10 月诊断为关节假体周围感染的患者 116 例，均行二期髋/膝关节翻修手术。术中取出至少 3 份假体周围组织进行细菌培养，将每份组织块平均分为两份，用 0.1%亚甲蓝注射液将其中一份组织染色，另一份作为对照组不做染色处理。比较两组最终的培养阳性率及细菌鉴定情况。［结果］ 116 例患者中亚甲蓝组的细菌培养阳性率为 81.89%，而非亚甲蓝组的细菌培养阳性率为 86.21%，差异无统计学意义（P=0.370）。从两组中相对应的组织块培养结果来看，亚甲蓝对产酸克雷伯菌和除溶血葡萄球菌之外的凝固酶阴性葡萄球菌有不同程度的抑菌作用，而对金黄色葡萄球菌、化脓链球菌、无乳链球菌、革兰阳性杆菌、粪肠球菌和屎肠球菌均无影响。［结论］亚甲蓝溶液可能会使关节假体周围感染中某种细菌的检出受到影响。

Abstract:

[Objective] To explore the effect of methylene blue (MB) , a disclosing agent, on bacterial culture in periprosthetic joint in- fection (PJI) . [Methods] A total of 116 patients who received two-stage revision surgeries for PJI secondary to hip or knee arthroplasty from October 2017 to October 2019 were included in the study. At least 3 periprosthetic tissues were harvested during surgery for bacterial cul- ture. Each tissue sample was divided into two equal parts, one was stained with 0.1% MB solution, while other one was used as a control group without MB staining. The consequences of bacterial culture and identification were compared between the two groups. [Results] The positive rate of bacterial culture was of 81.89% in the MB group, whereas 86.21% in the non-MB group, which proved not statistically signifi- cant between them (P=0.370) . As results of bacterial identification, MB had antimicrobial effects in some extent on Klebsiella oxytoca and Coagulase-negative Staphylococcus other than Staphylococcus haemolyticus. [Conclusion] MB solution might impact the detection of cer- tain bacteria in PJI.