Etiologic Diagnosis of Chronic Osteomyelitis (original) (raw)
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BMC infectious diseases, 2002
Prognosis of chronic osteomyelitis depends heavily on proper identification and treatment of the bone-infecting organism. Current knowledge on selecting the best specimen for culture is confusing, and many consider that non-bone specimens are suitable to replace bone cultures. This paper compares the microbiology of non-bone specimens with bone cultures, taking the last as the diagnostic gold standard. Retrospective observational analysis of 50 patients with bacterial chronic osteomyelitis in a 750-bed University-based hospital. Concordance between both specimens for all etiologic agents was 28%, for Staphylococcus aureus 38%, and for organisms other than S. aureus 19%. The culture of non-bone specimens to identify the causative organisms in chronic osteomyelitis produced 52% false negatives and 36% false positives when compared against bone cultures. Diagnosis and therapy of chronic osteomyelitis cannot be guided by cultures of non-bone specimens because their microbiology is subst...
Journal of Infection and Public Health, 2020
Background: The diagnosis of osteomyelitis is invasive and expensive as the current standard technique is the bone biopsy. Our aim was to compare the degree of agreement and concordance between standard bone biopsy and other non-bone techniques. Methods: We performed an electronic search through 12 electronic databases to retrieve relevant studeis. Our criteria included any original article that reported the degree of agreement and/or the concordance between bone biopsy and other non-bone techniques in diagnosing osteomyelitis. We published our protocol in PROSPERO with a registration number, CRD42017080336. Results: There were 29 studies included in the qualitative analysis, of which 15 studies were included in the meta-analysis. Samples from sinus tract had the highest concordance with bone biopsy samples, while swab samples were the least concordant with bone biopsy samples. Additionally, Abbreviations: COM, chronic osteomyelitis; S. aureus, Staphylococcus aureus; SR/MA, systematic review/meta-analysis; PRISMA, preferred reporting items for systematic review and meta-analysis checklist; ISI, web of science; VHL, virtual health library; GHL, WHO global health library; mRCT, controlled trials; SIGLE, system for information on grey literature in Europe.
IP innovative publication pvt. ltd, 2019
Introduction: Chronic osteomyelitis is a important medical illness among developing countries, it is a very expensive disease for the patient and society mostly associated with trauma and surgery as risk factors. There is a constant change in the trend of organisms involved and resistance pattern seen with advent of newer antibiotics, So early and specific therapy is needed. With this background present study aims to look for the varying trends of microorganisms involved in osteomyelitis and their antimicrobial susceptibility pattern. Materials and Methods: A total of 100 cases studied over a period of one year, samples processed by following standard laboratory protocols and along with routine antimicrobial testing screening for MRSA done. Results: Among 100 cases, 76 were males and 24 were females, between age group of 11 –60 years. Long bones are most involved with trauma (45%) as risk factor. Staphylococcus aureus (51%) predominant pathogen isolated with 27(53%) were MRSA, followed by Pseudomonas aeruginosa (16%). Antibiotic sensitivity testing of gram positive organisms showed hundred percent sensitivity to Linezolid and Vancomycin with poor sensitivity to Pencillin (10/15.6%). Among gram negative organisms, majority showed highest sensitivity to Amikacin (73.3%) & Imipenem (71.1%) with poor sensitivity to Ciprofloxacin (20.0%) and Ampicillin (0%). Conclusion: Chronic osteomyelitis is a prime challenging problem in many countries with severe morbidity. Mostly due to neglect, delayed or inadequate treatment and emerging drug resistant pathogens involved. Culture based antibiotic therapy helps in effectively treating the disease also prevents the drug resistance.
Journal of Infection, 2010
This study describes the microbiological spectrum of chronic osteomyelitis and so guides the choice of empirical antibiotics for this condition. Methods: We performed a prospective review of a 166 prospective patient series of chronic osteomyelitis from Oxford, UK in which a standardised surgical sampling protocol was used. Results: Staphylococcus aureus was most commonly isolated (32%) amongst a wide range of organisms including gram negative bacilli, anaerobes and coagulase negative staphylococci. Low grade pathogens were not confined to patients with a history of metalwork, a high proportion of cases were polymicrobial (29%) and culture negative cases were common (28%). No clear predictors of causative organism could be established. Many isolates were found to be resistant to commonly used empirical anti-microbial regimens. Conclusions: The wide range of causative organisms and degree of resistance to commonly used anti-microbials supports the importance of extensive intra-operative sampling and provides important information to guide clinicians' choice of empirical antibiotics.
Polymerase Chain Reaction molecular diagnostic technology for monitoring chronic osteomyelitis
Journal of Experimental Orthopaedics, 2014
Background: Osteomyelitis is a devastating condition whose treatment relies on the detection of bacteria. The current standard of microbiology culture may not be adequate. Molecular biology based diagnostic procedures for detecting bacteria in orthopaedic infections was previously established, but has not been applied to the setting of chronic osteomyelitis. We aim to determine the applicability of molecular diagnostic procedures for monitoring chronic osteomyelitis, and to evaluate if these procedures are superior to standard culture methods of osteomyelitis detection.
A comprehensive review of bacterial osteomyelitis with emphasis on Staphylococcus aureus
Microbial Pathogenesis, 2020
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Osteomyelitis: Etiology, Diagnosis, Treatment and Outcome in a Public versus a Private Institution
Infection, 2001
Although bone infections are difficult to diagnose and manage, primary health care providers often give comprehensive care to patients with few referrals. To evaluate how trends in care impact upon management of bone infections, we performed a retrospective review of medical records of 198 osteomyelitis patients. Patients and Methods: 130 patients were hospitalized at a private institution and 68 were hospitalized at a public (teaching) institution. Outcomes measured were bone salvage or loss in relation to predisposing co-morbidities and infectious disease (ID) physician involvement in the patient care. Results: Co-morbidities predominating at the public and private hospitals, respectively, were presence of metal implants (20% and 37%) and diabetes (32% and 31%). The most common pathogens at the public and private hospitals, respectively, were methicillin-susceptible Staphylococcus aureus (MSSA, 16 and 32%) and methicillin-resistant S. aureus (MRSA, 3% and 31%). ID specialists treated longer with iv antibiotics (42 and 43.5 median treatment days) than non-ID specialists (14 and 7 median treatment days). When ID specialists were involved in case management, a trend to bone salvage was seen at the public hospital (p < 0.09). Conclusion: Osteomyelitis patient outcome varies less by hospital setting than by case management.
European Journal of Orthopaedic Surgery & Traumatology
Introduction Chronic osteomyelitis (COM) is a devastating infection requiring a multidisciplinary approach, including radiology, microbiology, pathology, and orthopaedic surgery to treat. The present study analysed the bacterial profile causing chronic osteomyelitis and their antibiogram in our region. Patients and methods This prospective study was done on a consecutive group of patients who underwent surgical debridement for long bone COM. Three to six deep tissue samples were collected during the index debridement for microbiology and one sample for histopathology. Antimicrobial sensitivity testing used an automated bacterial identification system. Gram stain was used to identify the bacteria type from its size, shape, and arrangement of bacterial growth. Results Intra-operative deep tissue and bone specimens accurately identified causative bacteria in 84.8% of patients. Gram-ve bacilli (GNB) were the most common causative organisms in 51.6% of all growing samples (36.4% isolated...