Objective To determine the epidemiological, clinical and microbiological characteristics, of patients with post-traumatic osteomyelitis of extremity fractures, and provide evidence-based guidelines for early diagnosis and treatment, including empiric antibiotic therapy.Methods Human subject research was performed using institutional review board approved protocols. A retrospective chart review was conducted on 5,368 patients diagnosed with extremity traumatic fractures from January 1, 2012 to December 31, 2015, to identify osteomyelitis patients. Records from the Microbiology Department were reviewed, and patients with a positive wound culture, or bone biopsy culture, were selected for the study. Microbial suceptability was determined by the M-100-S22 protocol (Clinical & Laboratory Standards Institute® (CLSI) 2012 USA). Additional clinical information, including data on patients' baseline epidemiological, clinical, and microbiological records was collected from all available charts, and reviewed using a designed protocol.Results 84 (1.56%) patients were diagnosed with osteomyelitis based on a positive culture result. The most prevalent comorbidities in these patients were compartment syndrome, diabetes and hypertension. The most commonly involved infected site was the tibia-fibula (47.62%). 66 (78.57%) of these cases were monomicrobial, and 18 cases (21.43%) were polymicrobial. The infections were predominantly caused by Gram-positive bacteria (56, 53.85%). The most common Gram-positive bacteria were Staphylococcus aureus (39 cases, 37.50%) and S. epidermidis (6 cases, 5.77%), which were sensitive to ampicillin, synercid/ dalfopristin, linezolid, tigecycline, macrodantin, and vancomycin. S. aureus was the most common pathogen in both monomicrobial and polymicrobial cases. All 17 cases of MRSA infection were sensitive to Imezolid, ampicillin, synercid/ dalfopristin, linezolid, tigecycline, furadantin, piperacillin/yaz, rifampicin, and vancomycin, respectively. The most common Gram-negative bacteria were E. coli (16 cases, 15.38%) and Enterobacter cloacae (11 cases, 10.58%), which were sensitive to thienamycin.Conclusions In this study, the overall rate of post-traumatic osteomyelitis of limb fractures (1.56%) is lower than the national average rate (2.6-7.8%), for major medical centers in China. The main medical comorbidities were compartment syndrome, diabetes mellitus and hypertension. The most common infection was monomicrobial in lower extremities. S. aureus was the most common pathogen, which presented in 39 (37.50%) cases, and 17 of these (43.59%) were caused by MRSA. These findings can guide empiric antibiotic therapy in Southwest China for osteomyelitis in patients with traumatic limb fractures.

Transected axons are unable to regenerate after spinal cord injury (SCI). Glial scar is thought to be responsible for this failure. Regulating the formation of glial scar post-SCI may contribute to axonal regrow. Over the past few decades, studies have found that the interaction between immune cells at the damaged site results in a robust and persistent inflammatory response. Current therapy strategies focus primarily on the inhibition of subacute and chronic neuroinflammation after the acute inflammatory response was executed. Growing evidences have documented that mesenchymal stem cells (MSCs) engraftment can be served as a promising cell therapy for SCI. Numerous studies have shown that MSCs transplantation can inhibit the excessive glial scar formation as well as inflammatory response, thereby facilitating the anatomical and functional recovery. Here, we will review the effects of inflammatory response and glial scar formation in spinal cord injury and repair. The role of MSCs in regulating neuroinflammation and glial scar formation after SCI will be reviewed as well.

Bone infection represents a serious complication of orthopedic surgery and Staphylococcus aureus is the most common pathogen. To improve the understanding of host-pathogen interaction, we developed a biospecimen registry (AO Trauma CPP Bone Infection Registry) to collect clinical data, bacterial isolates, and serum from patients with S. aureus bone infection. A prospective multinational registry with a