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RFL - Revue francophone des laboratoires
Volume 2016, n° 480
pages 47-53 (mars 2016)
Doi : 10.1016/S1773-035X(16)30087-9
Diagnostic des infections ostéo-articulaires
Diagnosis of bone and joint infections
 

Céline Dupieux a, b, Frédéric Laurent a, b,
a Laboratoire de bactériologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon 
b Centre de Référence des Infections Ostéo-Articulaires Rhône-Alpes Auvergne (CRIOAc) 

*Correspondance.
Résumé

Le diagnostic microbiologique des infections ostéo-articulaires est complexe et nécessite une collaboration forte entre orthopédistes, infectiologues et biologistes. Il est obligatoire de réaliser des prélèvements dans les conditions les plus strictes d’asepsie au bloc chirurgical avec un acheminement rapide au laboratoire de bactériologie. La multiplication des prélèvements facilite l’interprétation des résultats. Une fois au laboratoire, ces prélèvements doivent être traités dans des conditions d’asepsie pour éviter toute contamination. L’incubation des milieux gélosés doit être prolongée (minimum 14 jours) pour permettre la culture de toutes les bactéries. L’identification et les antibiogrammes sur tous les types de colonies bactériennes sont d’ailleurs indispensables. La biologie moléculaire est utile en cas de forte suspicion d’infection alors que les cultures sont négatives ou systématiquement en cas d’arthrite septique de l’enfant de moins de 4 ans.

The full text of this article is available in PDF format.
Summary

Microbiological diagnosis of bone and joint infections is complex and needs strong collaboration between surgeons, infectious disease specialists and microbiologists. It is mandatory to take samples in the strictest conditions of asepsis in surgical unit with a quick delivery to the laboratory of Bacteriology. The multiplication of samples facilitates interpretation of results. In the lab, samples should be treated in aseptic conditions to avoid contamination. The incubation of the agar media has to be prolonged (14 days minimum) to allow the culture of all bacteria species. The bacterial identification and susceptibility testing on all types of bacterial colonies are also essential. Molecular biology is useful in case of strong suspicion of bone infection while cultures are negative or systematically in case of septic arthritis in children under 4 years.

The full text of this article is available in PDF format.

Mots-clés : Infections ostéo-articulaires, prélévement, examen direct, culture, biologie moléculaire

Keyword : Bone and joint infections, samples, diagnosis, culture, molecular biology




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