Culture of Percutaneous Bone Biopsy Specimens For Diagnosis of Diabetic Foot Osteomyelitis: Concordance With Ulcer Swab Cultures

Senneville, Éric; Melliez, H.; Beltrand, E.; Legout, L.; Valette, M.; Cazaubie, Marie; Cordonnier, M.-O.; Caillaux, M.; Yazdanpanah, Yazdan; Mouton, Y

doi:10.1086/498112

Cited by 281 publications

(238 citation statements)

References 22 publications

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“…In addition, it had to be confirmed by a positive culture of a transcutaneous bone biopsy performed after an antibiotic-free period of at least 2 weeks as described earlier by our group (10). Patients who had gangrene and who required bone resection because of bone and/or joint destruction or amputation due to severe peri-osteoarticular damage were not included.…”

Section: Populationmentioning

confidence: 99%

Six-Week Versus Twelve-Week Antibiotic Therapy for Nonsurgically Treated Diabetic Foot Osteomyelitis: A Multicenter Open-Label Controlled Randomized Study

et al. 2014

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OBJECTIVELittle is known about the optimal duration of antibiotic therapy for diabetic foot osteomyelitis (DFO). This study sought to compare the effectiveness of 6 versus 12 weeks of antibiotic therapy in patients with DFO treated nonsurgically (i.e., antibiotics alone). RESEARCH DESIGN AND METHODSThis was a prospective randomized trial comparing 6-versus 12-week duration of antibiotic treatment. Remission of osteomyelitis during the monitoring period was defined as complete and persistent (>4 weeks) healing of the wound (if present initially), absence of recurrent infection at the initial site or that of adjacent rays, and no need for surgical bone resection or amputation at the end of a follow-up period of at least 12 months after completion of antibiotic treatment. RESULTSForty patients followed at five French general hospitals were randomized be-

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Section: Populationmentioning

confidence: 99%

Six-Week Versus Twelve-Week Antibiotic Therapy for Nonsurgically Treated Diabetic Foot Osteomyelitis: A Multicenter Open-Label Controlled Randomized Study

et al. 2014

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“…In diabetic foot infections, the role of anaerobic bacteria is particularly unclear; some studies have reported that anaerobic bacteria play a minor role (20) (21) , while other studies found a high incidence of anaerobic bacteria (5) (22) .…”

Section: Discussionmentioning

confidence: 99%

Aerobic bacterial profile and antibiotic resistance in patients with diabetic foot infections

Perim

Borges

Celeste

et al. 2015

Rev. Soc. Bras. Med. Trop.

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“…One limitation of this study is that data on the microbial isolates of the infections were not collected. We rarely take superficial swabs of wounds because they are unreliable culture specimens (51)(52)(53). Thus, most of our cultures were of deep tissue and therefore obtained only for the more severe wounds.…”

Section: Statistical Analysesmentioning

confidence: 99%

Risk Factors for Foot Infections in Individuals With Diabetes

Lavery

Armstrong

Wunderlich³

et al. 2006

Diabetes Care

629

414

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OBJECTIVE -To prospectively determine risk factors for foot infection in a cohort of people with diabetes.RESEARCH DESIGN AND METHODS -We evaluated then followed 1,666 consecutive diabetic patients enrolled in a managed care-based outpatient clinic in a 2-year longitudinal outcomes study. At enrollment, patients underwent a standardized general medical examination and detailed foot assessment and were educated about proper foot care. They were then rescreened at scheduled intervals and also seen promptly if they developed any foot problem.RESULTS -During the evaluation period, 151 (9.1%) patients developed 199 foot infections, all but one involving a wound or penetrating injury. Most patients had infections involving only the soft tissue, but 19.9% had bone culture-proven osteomyelitis. For those who developed a foot infection, compared with those who did not, the risk of hospitalization was 55.7 times greater (95% CI 30.3-102.2; P Ͻ 0.001) and the risk of amputation was 154.5 times greater (58.5-468.5; P Ͻ 0.001). Foot wounds preceded all but one infection. Significant (P Ͻ 0.05) independent risk factors for foot infection from a multivariate analysis included wounds that penetrated to bone (odds ratio 6.7), wounds with a duration Ͼ30 days (4.7), recurrent wounds (2.4), wounds with a traumatic etiology (2.4), and presence of peripheral vascular disease (1.9).CONCLUSIONS -Foot infections occur relatively frequently in individuals with diabetes, almost always follow trauma, and dramatically increase the risk of hospitalization and amputation. Efforts to prevent infections should be targeted at people with traumatic foot wounds, especially those that are chronic, deep, recurrent, or associated with peripheral vascular disease.

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Culture of Percutaneous Bone Biopsy Specimens For Diagnosis of Diabetic Foot Osteomyelitis: Concordance With Ulcer Swab Cultures

Abstract: These results suggest that superficial swab cultures do not reliably identify bone bacteria. Percutaneous bone biopsy seems to be safe for patients with diabetic foot osteomyelitis.

Cited by 281 publications

References 22 publications

Six-Week Versus Twelve-Week Antibiotic Therapy for Nonsurgically Treated Diabetic Foot Osteomyelitis: A Multicenter Open-Label Controlled Randomized Study

Six-Week Versus Twelve-Week Antibiotic Therapy for Nonsurgically Treated Diabetic Foot Osteomyelitis: A Multicenter Open-Label Controlled Randomized Study

Aerobic bacterial profile and antibiotic resistance in patients with diabetic foot infections

Risk Factors for Foot Infections in Individuals With Diabetes

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