Microorganisms Associated With Osteomyelitis of the Foot and Ankle

King, Christy M.; Castellucci-Garza, Francesca M.; Lyon, Liisa; Doyle, Matthew D.; Williams, Mitzi L.

doi:10.1053/j.jfas.2019.08.032

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…On the one hand, in hematogenous osteomyelitis, bacteremia and the seeding of bones from distant sites are involved. On the other hand, contiguous spread involves direct inoculation into adjacent bone tissues, open fractures, penetrating injuries, or nosocomial contamination [88,89]. In the current case, it is believed that the primary mechanism of DFO development was contiguous spread through direct inoculation into adjacent bone tissues.…”

Section: Clinical and Epidemiological Characteristics Of Dfi And Dfomentioning

confidence: 73%

Diabetic Foot Osteomyelitis Caused by Co-Infection with Methicillin-Resistant Staphylococcus aureus and Multidrug-Resistant Extended-Spectrum ß-Lactamase-Producing Escherichia coli: A Case Report

Kitaya,

Miura,

Suzuki

et al. 2023

Applied Microbiology

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This case report describes a 47-year-old man with type 2 diabetes and its associated complications. The patient developed co-infection with methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant (MDR) extended-spectrum ß-lactamase (ESBL)-producing Escherichia coli following surgical amputation for osteomyelitis caused by diabetic foot infection (DFI). The patient had a history of recurrent hospitalization due to DFI and had received multiple antimicrobials. Intraoperative wound cultures identified MRSA and MDR ESBL-producing E. coli as the causative agents of the co-infection. Intravenous vancomycin and meropenem were administered. After surgery, daily debridement and hyperbaric oxygen therapy were performed. The patient underwent surgical wound closure and was discharged on day 86. Polymicrobial infections in DFIs worsen antimicrobial resistance, impede wound healing, and increase the risk of osteomyelitis and amputation. Furthermore, infections caused by MDR bacteria exacerbate challenges in infection control, clinical treatment, and patient outcomes. In DFI cases caused by co-infection with MDR bacteria, prompt and appropriate antimicrobial therapy, debridement, and regular wound care while considering transmission are essential.

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Section: Clinical and Epidemiological Characteristics Of Dfi And Dfomentioning

confidence: 73%

Diabetic Foot Osteomyelitis Caused by Co-Infection with Methicillin-Resistant Staphylococcus aureus and Multidrug-Resistant Extended-Spectrum ß-Lactamase-Producing Escherichia coli: A Case Report

Kitaya,

Miura,

Suzuki

et al. 2023

Applied Microbiology

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“…Moreover, in our cohort of patients, most pathogens were Gram-positive bacteria, and Meticillin-Sensitive Staphylococcus Aureus was the most common, according to literature data. 23 , 29 In fact, it is well known that S. Aureus is a bacterium frequently involved in skin, soft tissue, bone, and joint infection. 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

The Role of Serial Radiographs to Diagnose Diabetic Foot Bone Infection.

Leone

Bianco

D’Ambra

et al. 2022

Mediterr J Hematol Infect Dis

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Purpose: To evaluate the role of progressive radiographic changes to diagnose diabetic foot osteomyelitis. Materials and Methods: A retrospective review of databases of our Institution was performed to identify all long-standing diabetic foot patients who underwent two radiographic examinations spaced no more than five weeks apart and a subsequent magnetic resonance (MR) examination from November 2015 to November 2020. A total of 46 patients (32 men, 14 women; mean age, 57.3 years) were identified. Results: serial radiographs showed 89% sensitivity, 38% specificity, 80% diagnostic accuracy, 87% positive predictive value (PPV), 43% negative predictive value (NPV) to diagnose osteomyelitis (P value < 0,05). Bone destruction was the most reliable radiographic sign with 89% sensitivity, 88% specificity, 89% diagnostic accuracy, 97% PPV, 64% NPV (P value < 0,05). Conclusion: Progressive bony changes detected by serial radiographs are a useful tool to diagnose diabetic foot osteomyelitis.

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“…In this study, 16 different microorganisms were identified based on the intraoperative samples, and this is supposed to be related to geographic regional discrepancies 25,30,58 in the enrolled patients. S aureus 45 and P aeruginosa , 50 as the most common microorganisms identified in both groups, were effectively inhibited after either CS or IS treatment due to continuous release of high antibiotic concentration, regardless of the microorganisms’ biofilm formation on necrotic bone tissue and within the osteocyte-lacuna canicular networks of live bone.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic-Impregnated Calcium Sulfate vs. Wound Irrigation-Suction to Treat Chronic Calcaneal Osteomyelitis

Song

Ren

et al. 2021

Foot Ankle Int.

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Background: Chronic osteomyelitis of calcaneus is not rare but is very hard to treat. Irrigation-suction and antibiotic-impregnated calcium sulfate following debridement are commonly used in managing chronic osteomyelitis, but their effects have rarely been compared. We aimed to compare the effectiveness of antibiotic-impregnated calcium sulfate with irrigation-suction in the treatment of patients with chronic calcaneal osteomyelitis. Methods: From January 2011 to June 2018, adult patients at our institute with chronic osteomyelitis receiving treatment of either antibiotic-impregnated calcium sulfate (CS group) or irrigation-suction (IS group) following thorough debridement were screened and selected according to the inclusion and exclusion criteria. The clinical presentation, laboratory tests, complications, and the ultimate single-staged cure rate and recurrence were compared. Results: A total of 61 patients, including 41 in the CS group and 20 in the IS group, were included in our study. Of the patients, 85.4% in the CS group and 60.0% in the IS group ( P = .006) were successfully cured in the single stage, respectively, without infection recurrence. Lower infection recurrence rates with shorter hospital stay were found in the CS group than the IS group. Inflammatory biomarkers after surgery with both treatments were slightly decreased and not significantly different from preoperative or between-groups postoperative. Exudate from incision was found primarily in the CS group. Conclusion: This study demonstrates that both antibiotic-impregnated calcium sulfate and irrigation-suction after careful and thorough surgical debridement are generally effective in treating chronic calcaneal osteomyelitis. Antibiotic-impregnated calcium sulfate achieved a higher single-staged cure rate but was associated with an increased postoperative wound exudate. Level of Evidence: III, retrospective cohort study.

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Microorganisms Associated With Osteomyelitis of the Foot and Ankle

Cited by 8 publications

References 20 publications

Diabetic Foot Osteomyelitis Caused by Co-Infection with Methicillin-Resistant Staphylococcus aureus and Multidrug-Resistant Extended-Spectrum ß-Lactamase-Producing Escherichia coli: A Case Report

Diabetic Foot Osteomyelitis Caused by Co-Infection with Methicillin-Resistant Staphylococcus aureus and Multidrug-Resistant Extended-Spectrum ß-Lactamase-Producing Escherichia coli: A Case Report

The Role of Serial Radiographs to Diagnose Diabetic Foot Bone Infection.

Antibiotic-Impregnated Calcium Sulfate vs. Wound Irrigation-Suction to Treat Chronic Calcaneal Osteomyelitis

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