Culture-Negative Infections in Orthopedic Surgery
Laboratory cultures are the main scientific input into the decision-making process that determines the course of treatment for suspected orthopedic infections, just as they constitute the mainstay of the diagnosis of infections in other medical specialties. This situation is archaic because culture techniques were virtually abandoned in Environmental Microbiology (Hugenholtz et al. 1998) many years ago, following the conclusion that <1% of the bacteria in any natural ecosystem can be recovered by standard cultural methods. Medical Microbiology has clung to culture techniques because they detect the bacteria that cause acute infections, with reasonable sensitivity and accuracy, but the time has come to examine both their sensitivity and their accuracy for the detection and identification of bacteria in chronic biofilm infections (Costerton et al. 1999).
KeywordsOtitis Medium With Effusion Vaginal Flora Multicellular Aggregate Base Ratio Chronic Bacterial Infection
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