利多卡因对细菌培养影响的实验研究  

Impact of lidocaine on bacterial culture: an experimental study

作　　者：谭冠中 刘侃 陈继营[3] 罗燕萍[3] 郝立波[3] TAN Guan-zhong;LIU Kan;CHEN Ji-ying;LUO Yan-ping;HAO Li-bo(Nanning Hospital of Traditional Chinese Medicine,Nanning 530012,China;Third Affiliated Hospital,Beijing University of Chinese Medicine,Beijing100029,China;General Hospital of PLA,Beijing100853,China)

机构地区：[1]广西壮族自治区南宁市中医医院,广西南宁530012 [2]北京中医药大学第三附属医院,北京100029 [3]中国人民解放军总医院,北京100853

出　　处：《中国矫形外科杂志》2019年第14期1302-1305,共4页Orthopedic Journal of China

基　　金：国家自然科学基金面上项目(编号:81672192)

摘　　要：[目的]探讨利多卡因对细菌培养结果的影响,为临床关节假体周围感染(periprosthetic joint infection,PJI)提高细菌培养阳性率提供理论依据。[方法]制备8种标准菌株,包括金黄色葡萄球菌、表皮葡萄球菌、人葡萄球菌、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、化脓链球菌和白色念珠菌的菌悬液(3×10^6CFU/ml),模拟临床PJI的关节滑液。各标准菌株的菌悬液分为两组,利多卡因组为2%利多卡因100μl+菌悬液600μl,盐水组为0.45%无菌生理盐水100μl+菌悬液600μl,混匀1 min后,分别接种于5个琼脂平板培养基上进行24 h定量培养,通过菌落计数比较两组培养基上的细菌生长情况。[结果]24 h定量细菌培养结果表明,利多卡因组金黄色葡萄球菌、表皮葡萄球菌、人葡萄球菌、大肠杆菌、肺炎克雷伯杆菌、鲍曼不动杆菌、白色念珠菌菌株的菌落计数显著低于盐水组,差异均有统计学意义(P<0.05),而两组间化脓链球菌菌株的菌落计数差异无统计学意义(P>0.05)。[结论]2%利多卡因注射液对临床中常见的PJI病原菌具有很强的抗菌作用。因此,在关节液取样前使用2%利多卡因注射液进行局部浸润麻醉可能影响细菌培养结果。[Objectives] To explore the effect of lidocaine, a local anesthetic, on bacterial culture, and provide theoretical basis for improving the positive rate of bacterial culture for prosthetic joint infections(PJI) in clinical setting. [Methods] A total of 8 reference bacterial strain suspensions were prepared in concentration of(3í10~6 CFU/mL), including Staphylococcus aureus,Staphylococcus epidermidis, Staphylococcus hominis, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Streptococcus pyogenes, and Candida albicans to simulate the synovial fluid of PJI in clinical setting, which were divided into two groups respectively. The lidocaine group was consisted of 2% lidocaine 100μL and the bacterial suspensions 600μL, while the saline group contained 0.45% saline 100μL and the bacterial suspensions 600μL. After mixed for 1 min, the suspensions were incubated on agar medium, and cultured for 24 hours. The bacteria growth was quantitated by colony counting. [Results] As results of quantitative bacterial culture for 24 hours, the lidocaine group had significantly less colony count than the saline group regarding to Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumoniae and Acinetobacter baumanniion, Candida albicans, Escherichia coli, Staphylococcus hominis(P<0.05), although the colony count proved no statistically significant in Streptococcus pyogenes between the two groups(P>0.05). [Conclusion] As 2% lidocaine has strong antimicrobial activities against some commonly encountered bacterial strains in PJI, local infiltration anesthesia with 2% lidocaine before the arthrocentesis might affect the results of bacterial culture with the synovial fluid.

关 键 词：细菌培养 利多卡因 盐水 关节假体周围感染 

分 类 号：R318[医药卫生—生物医学工程]