最新Diagnosis of Periprosthetic Infection by Using ESR and CRP ：用ESR和CRP诊断假体周围感染-药学医学精品资料.ppt

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1、最新DiagnosisofPeriprostheticInfectionbyUsingESRandCRP：用ESR和CRP诊断假体周围感染-药学医学精品资料Periprostheticjointinfection(PJI)1.5%–2.5%afterprimaryhiporkneearthroplastyMarkedmorbidityandmortalityChallengingPeriprostheticjointinfection(PJI)EffectivedeliveryofantibioticsBasedonthetypeandantibioticsensitivityof

2、theinfectingorganismMaterialsandMethodsCriteriafordiagnosisofinfection:PositivepreoperativeaspirationCultures,GramstainsPositiveintraoperativeCultures,Gramstainsand/orthepresenceofanabscessorsinustractcommunicatingwiththejointspaceClinicalsuspicionAbnormalserologyProcedureperformedProcedureNum

3、berPercentTw0-stageexchange24263%One-stageexchange339%I&D10226%Amputation10.3%Other61.7%ResultsGrampositivecoccicause90%ofPJI,andgramnegativeorganismsaccountformostoftheremaininginfections.Grampositivein269cases(89.7%)Gramnegativein30cases(10%)Fungusin1case(0.3%)Results-IntraoperativeculturesD

4、iagnosisofPJIwasbasedonPositiveIntraoperativeculturesin309patients(80%)20%FalseNegativeResults-IntraoperativeGRAMSTAIN340patients-89%-hadGramstainperformed71patientshadPositiveresult-(21%)269patients–(79%)FalseNegativeResults-GramStain(Aspiration)276patients-72%hadpre-operativeAspiration93pat

5、ients(34%)hadpositiveGRAMstains217patients(66%)hadfalsenegativeresultsResults-Culture(Aspiration)276patients-72%hadpre-operativeAspiration217patients(79%)hadPositiveCULTUREresults59patients(21%)hadfalsenegativeresultsResults-OverallGramStainCultureAspiration34%79%Intra-Operative21%80%ResultsCu

6、ltureswerenegativeoverallin53cases(14%)thatsatisfieddefinedcriteriafordiagnosisofPJIInfectingOrganismwasidentifiedin331cases(86%)GRAMSTAINNo.ofPatientsPositiveResultFalseNegativeAspiration276(72%)93(34%)183(66%)Intra-Operative340(89%)71(21%)269(79%)CULTUREAspiration276(72%)217(79%)59(21%)Intra

7、-operative384(100%)300(80%)84(20%)OVERALL384(100%)333(86%)51(14%)Results-OutcomeSF-36WOMACHSS/KSSSuccessforeradicationofinfectionBetterforculturepositive85%vs75%forfalsenegativeBetterforculturepositiveConclusionsTheinabilitytoisolateani