Need for appropriate specimen for microbiology diagnosis of chronic osteomyelitis

Abstract

INTRODUCTION:Chronic osteomyelitis (COM) is a common infection, especially in developing countries. An adequate bone biopsy specimen processed with appropriate microbiology culture methods for isolation and identification of the causative organisms is considered as the gold standard for the diagnosis of osteomyelitis.MATERIALS AND METHODS:The present study is a retrospective microbiology analysis of the specimen from 219 clinically diagnosed cases of COM between January 2013 and April 2016.RESULTS:The overall culture positivity was 111/219 (50. 6%), colonization was seen in 22/219 (10.5%), while the rest 86/219 (39.3%) were culture-negative specimen; culture positivity was highest from tissue specimen (71/113, 62.8%). Among the swabs, 40/106 (37.7%) were culture positive. About 28/40 (70%) culture-positive swabs showed significant growth of Gram-positive organisms. Colonization with skin flora such as diphtheroids and Coagulase-negative Staphylococci was seen in 22/106 (20.7%) of the swabs. Sterile cultures (44/106, 41.6%) were high among the swab specimen. Gram-positives were most common (75/111, 67.56%). Staphylococcus aureus was the predominant organism isolated in 70/111 (63%) cases. Gram-negative bacilli showed a high level of antibiotic resistance.CONCLUSION:As per our data, the culture yield from wound swabs was low or contaminated with normal skin flora, as compared to the biopsy or tissue specimen. Hence, an appropriate sampling of the infected bone using recommended protocols is highly essential for improving microbiological yield and the outcome of COM.

A study to isolate various bacteria causing osteomyelitis in a tertiary health care setup

“…Vemu et al reported that OM can occur at any age and can involve any bone [16] and Kao HC et al in their study mentioned that 13 to 17 years is the common age for hematogenous OM [17]. Whereas acute OM was reported to be common among children, as per the Carek PJ et al study [18] and 0-16 years was reported to be the common age group for acute OM by Gavilan et al study [19].…”

Microbiological profile of chronic osteomyelitis with special reference to anaerobic osteomyelitis in a tertiary care hospital of coastal Karnataka

“…16 Aerobic organisms are the major culprits in chronic cases of osteomyelitis, with S. aureus being the most frequent pathogen. 1,3,4,10 However, anaerobic bacteria are reported with frequency rates in the range of 2%-29% of infections worldwide. 2,8,[17][18][19] Nevertheless, there are reports of anaerobes being aetiological agents in osteomyelitis in up to 77% of cases.…”

“…Chronic osteomyelitis is a catastrophic sequel of bone and joint infection that arises on account of delay in diagnosis and management of the acute stage of the disease. 10,14 Contiguous spread from exogenous or endogenous foci is common. 3,15 Prior exposure to antibiotic therapy, tubercular and fungal osteomyelitis that demand specialised culture techniques, the presence of biofilms and failure to recognise small colony variants can all result in negative bacteriological culture reporting.…”

“…The microbiological diagnosis of chronic osteomyelitis depends on the proper collection and transport of good quality specimens combined with an extensive bacteriological workup. 10 The surge in antimicrobial resistance and consequent higher rates of relapse means treating this ailment still demands extensive expertise. 3,4 In view of the paucity of data regarding chronic anaerobic osteomyelitis, our study was conceived.…”

“…The microbiological diagnosis of chronic osteomyelitis depends on the proper collection and transport of good quality specimens combined with an extensive bacteriological workup. 10…”