Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.190063
Jornal Vascular Brasileiro
Original Article

Existe concordância entre as culturas de osso e tendão em pacientes com lesões profundas de extremidades?

Is there concordance between bone and tendon cultures in patients with foot tissue loss?

Vanessa Prado dos Santos; Carlos Alberto Silveira Alves; André Brito Queiroz; Maria Goreth Matos de Andrade Barberino; Ronald José Ribeiro Fidelis; Cícero Fidelis; José Siqueira de Araújo Filho

http://dx.doi.org/10.1590/1677-5449.190063 J Vasc Bras, vol.18, e20190063, 2019
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Resumo

Resumo: Contexto: As infecções profundas de extremidades representam um desafio para o salvamento de membro dos pacientes.

Objetivos: Investigar se existe concordância entre as culturas de osso e tecido profundo em pacientes com lesões tróficas de extremidades.

Métodos: Foi realizado um estudo retrospectivo incluindo 54 pacientes com lesões tróficas profundas de extremidades internados, no Complexo Hospitalar Universitário Professor Edgard Santos, Salvador (BA), Brasil. Foram incluídos todos os pacientes que realizaram culturas de lesões tróficas profundas, com duas modalidades de coleta de exame: osso e fragmentos de tendão profundo. Analisaram-se a concordância, o número total de microrganismos e o número de microrganismos de acordo com a coloração de Gram em ambas as amostras.

Resultados: Entre os 54 doentes incluídos na amostra, a média de idade foi de 63,6 anos, 80% apresentavam DAOP, 70% eram diabéticos, e 72% hipertensos. Estudando as culturas dos 54 pacientes, 28 amostras (52%) foram completamente concordantes, sendo cultivados os mesmos microrganismos nos fragmentos de tendão profundo e de osso. Houve discordância parcial em 13 amostras (24%), e discordância total em 13 (24%). Observou-se que cresceu em média 1,62 microrganismo nos fragmentos de tendão profundo, e 1,72 nas amostras de osso. Analisando separadamente os microrganismos gram-positivos, a média de espécies cultivadas foi de 0,48 em tendão e de 0,44 em tecido ósseo. Por outro lado, para os microrganismos gram-negativos, a média de microrganismos cultivados foi de 1,14 e 1,27 nas amostras de tendão e de osso, respectivamente.

Conclusões: Cerca de metade dos pacientes portadores de lesões tróficas profundas de extremidades apresentaram concordância total entre as culturas de osso e de tendão.

Palavras-chave

análise microbiológica, infecção de feridas, pé diabético

Abstract

Abstract: Background: Deep infections of the extremities are a challenge that threaten limb salvage.

Objective: To investigate whether the results of bone and deep tissue cultures from patients with trophic limb ulcers coincide.

Methods: A retrospective study was conducted with data from 54 patients with deep trophic limb ulcers admitted to the Complexo Hospitalar Universitário Professor Edgard Santos, Salvador (BA), Brazil. The study analyzed all patients for whom cultures of material from foot wounds in patients with tissue loss had been performed using two specimen types: bone and fragments of deep tendon. The study analyzed concordance between the two sample types and total number of microorganisms and numbers of microorganisms by Gram staining in both samples.

Results: The mean age of the 54 patients in the sample was 63.6 years, 80% had PAOD, 70% were diabetic, and 72% were hypertensive. Analysis of the cultures showed that 28 (52%) pairs of samples from the 54 patients exhibited complete concordance, with the same microorganisms grown from fragments of deep tendon and bone. There was partial disagreement in 13 samples (24%) and total disagreement in 13 (24%). On average, 1.62 microorganisms were isolated from deep tendon fragments and 1.72 were isolated from bone samples. Analyzing Gram-positive microorganisms separately, the mean number of species grown was 0.48 for tendon cultures and 0.44 for bone cultures. In contrast, the mean number of Gram-negative microorganisms isolated was 1.14 for tendon samples and 1.27 for bone samples.

Conclusions: Around half of the patients with foot tissue loss had bone and tendon cultures that coincided exactly.
 

Keywords

microbiological analysis, wound infections, diabetic foot

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