How Do Preoperative Antibiotics Affect Culture Yield in Diabetic Foot Infections?

Young, Heather; Miller, Whitney; Burnham, Randy I.; Heard, Susan; Berg, Chrystal; Jenkins, Timothy C

doi:10.1093/ofid/ofx016

Cited by 12 publications

(15 citation statements)

References 12 publications

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“…Perhaps the observed difference described by Marco de Lucas et al was confounded by inadequate sample volume. Analyses looking specifically at the impact of antimicrobials on bone biopsy culture yield have similarly found no association [19,28,29].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Computed Tomography-Guided Percutaneous Spine Biopsies in Determining a Causative Organism in Cases of Suspected Infection: A Systematic Review

et al. 2019

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Purpose In suspected spondylodiscitis and vertebral osteomyelitis, computed tomography (CT)-guided biopsies are often performed to determine a causative organism and guide antimicrobial therapy. The aim of this study is to determine the diagnostic culture yield of CT-guided biopsies performed in cases of suspected spinal infections. Methods A literature search of PubMed and MEDLINE up to April 2017 was performed for keywords “CT guided vertebral biopsy infection,” “CT-guided spine biopsy infection,” “CT guided spine biopsy yield,” and “CT guided vertebral biopsy yield.” Inclusion criteria primarily consisted of studies exclusively using CT-guided biopsies in cases of suspected infectious lesions only. After study selection, published articles were analysed to determine diagnostic culture yield. Descriptive statistics were applied. Results 220 search results were screened; 11 met our inclusion criteria and were reviewed. In total, 647 biopsies of suspected infectious spinal lesions were performed. Positive cultures were obtained in 241 cases. Upon excluding one paper's skewed results, the net pooled results culture yield was 33%. Several cultures grew multiple organisms, leading to a total of 244 species identified. Most common isolated organisms include S taphylococcus aureus (n = 83), coagulase-negative S taphylococcus (n = 45), and Mycobacteria (n = 38). Conclusions The diagnostic culture yield of CT-guided biopsies in cases of suspected spinal infection is 33%. In the majority of cases, a causative organism is not identified. This suggests that improvements can be made in biopsy technique and specimen transfer to optimize culture yield and increase the clinical value of the procedure.

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Section: Discussionmentioning

confidence: 99%

The Efficacy of Computed Tomography-Guided Percutaneous Spine Biopsies in Determining a Causative Organism in Cases of Suspected Infection: A Systematic Review

et al. 2019

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“…In order to increase the sensitivity of the culture results, it is recommended that samples be taken before empirical antimicrobial therapy or, when antimicrobials are already used, after they could be discontinued for several days and samples collected if the patients are stable [ 6 11 ]. Increasing duration of preoperative antibiotic exposure has been associated with less frequent growth of streptococci and anaerobes and more frequent culture-negative results [ 14 ]. Swab specimens are not recommended for culture because of less accurate results; however, aseptically obtained deep tissues are recommended [ 15 16 ].…”

Section: Microbiologymentioning

confidence: 99%

“…In most centers, including Korea, S. aureus is the most frequently isolated, and perhaps most virulent pathogen, whether alone or in combination [ 11 ]. Aerobic Gram-positive cocci, especially S. aureus and Streptococcus species, are the predominant pathogens in DFIs and usually cause monomicrobial infection in previously untreated acute infections [ 9 14 23 ]. Polymicrobial infections, which may include various types of aerobes such as S. aureus, Streptococcus , Enterococcus, Enterobacteriaceae, and Pseudomonas commonly appear in deep or chronic wounds [ 11 24 ].…”

Section: Microbiologymentioning

confidence: 99%

Microbiology and Antimicrobial Therapy for Diabetic Foot Infections

Kwon

Armstrong

2018

Infect Chemother

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In addition to being the prime factor associated with amputation, diabetic foot infections (DFIs) are associated with major morbidity, increasing mortality, and reduced quality of life. The choice of appropriate antibiotics is very important in order to reduce treatment failure, antimicrobial resistance, adverse events, and costs. We reviewed articles on microbiology and antimicrobial therapy and discuss antibiotic selection in Korean patients with DFIs. Similar to Western countries, Staphylococcus aureus is the most common pathogen, with Streptococcus, Enterococcus, Enterobacteriaceae and Pseudomonas also prevalent in Korea. It is recommended that antibiotics are not prescribed for clinically uninfected wounds and that empirical antibiotics be selected based on the clinical features, disease severity, and local antimicrobial resistance patterns. Narrow-spectrum oral antibiotics can be administered for mild infections and broad-spectrum parenteral antibiotics should be administered for some moderate and severe infections. In cases with risk factors for methicillin-resistant S. aureus or Pseudomonas, empirical antibiotics to cover each pathogen should be considered. The Health Insurance Review and Assessment Service standards should also be considered when choosing empirical antibiotics. In Korea, nationwide studies need to be conducted and DFI guidelines should be developed.

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“…It is vital to obtain blood cultures: diagnostic yield has increased in recent years due to the introduction of real-time 16S rRNA testing for K. kingae [20] . Cultures should be obtained prior to the administration of antibiotic therapy: in adult studies, antibiotic administration has been shown to decrease the growth of streptococcal species in cultures [21] .…”

Section: Diagnosis: Laboratory Testsmentioning

confidence: 99%

“…Clinicians should be vigilant for abnormal positioning of the hip: the hip is often held in flexion, abduction and external rotation in septic arthritis to maximise the capsular volume. In infants, asymmetry of the hip joint space due to an increase in the medial joint space (Waldenstrom's sign [22] ) may be present but can be subtle sign.…”

Section: Septic Arthritismentioning

confidence: 99%

Overview of Paediatric Bone and Joint Infections

Barnes

Beverstock

2019

International Journal of Orthopaedics

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Paediatric bone and joint infections are common, and can be challenging to diagnose due to significant variation in the signs and symptoms depending on the age of the patient, site of infection and causative organism. Both septic arthritis and osteomyelitis are common, often co-existing. Surgeons must have a consistent approach to investigation and management of these patients to minimise morbidity from unrecognised or undertreated infection. We provide an overview of the epidemiology, presentation, investigation and management of both septic arthritis and osteomyelitis in children.

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How Do Preoperative Antibiotics Affect Culture Yield in Diabetic Foot Infections?

Cited by 12 publications

References 12 publications

The Efficacy of Computed Tomography-Guided Percutaneous Spine Biopsies in Determining a Causative Organism in Cases of Suspected Infection: A Systematic Review

The Efficacy of Computed Tomography-Guided Percutaneous Spine Biopsies in Determining a Causative Organism in Cases of Suspected Infection: A Systematic Review

Microbiology and Antimicrobial Therapy for Diabetic Foot Infections

Overview of Paediatric Bone and Joint Infections

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