Osteomyelitis

Zimmerli, Werner

doi:10.1002/9781118581742.ch13

Cited by 3 publications

(1 citation statement)

References 52 publications

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“…In other instances, certain osteomyelitic cases are not caused by microbial infections and exhibit auto-inflammatory bone disorders, e.g., chronic nonbacterial osteomyelitis ( Buch et al, 2019 ). The diverse forms of osteomyelitis are classified according to differentiating features, such as pathogenesis, duration of infection, localization, implant presence, anatomy, and co-morbidity ( Zimmerli, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Impact of the Host-Microbiome on Osteomyelitis Pathogenesis

Xiong

Qin

et al. 2021

Front. Mol. Biosci.

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The microbiome is a collection of genomes from microbiota, including all microorganisms in a niche, through direct and indirect interactions with the host. Certain microorganisms can exist in areas conventionally considered to be sterile, such as the bone matrix. Osseous microbiota dysbiosis caused by host-microbiome perturbation or external infections may ultimately lead to osteomyelitis, a bone inflammatory disorder. Our review covers the current discoveries on the impact of host-microbiome on osteomyelitis and some common osseous diseases. Some studies suggest that the microbiotas from both osseous and non-osseous tissues (e.g., blood or gut) impact the pathogenicity of osteomyelitis and other osseous diseases (e.g., rheumatoid arthritis). We believe that this review will provide readers with a better understanding on the role of the microbiome to the host’s bone health.

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Section: Introductionmentioning

confidence: 99%

Impact of the Host-Microbiome on Osteomyelitis Pathogenesis

Xiong

Qin

et al. 2021

Front. Mol. Biosci.

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Orthopaedic biofilm infections

Zimmerli

Sendi

2017

APMIS

257

200

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Zimmerli W, Sendi P. Orthopaedic biofilm infections. APMIS 2017; 125: 353-364. Many infections of the musculoskeletal system are biofilm infections that develop on non-living surfaces. Microorganisms adhere either on dead bone (sequesters) or implants. As a rule for a curative concept, chronic osteomyelitis or implant-associated bone infection must be treated with a combination of surgery and antimicrobial therapy. If an implant is kept in place, or a new device is implanted before complete healing of infection, a biofilm-active antibiotic should be used. Rifamycins are active against biofilms of staphylococci, and fluoroquinolones against those of Gramnegative bacilli. In this review, the management of chronic osteomyelitis, periprosthetic joint infection and implantassociated osteomyelitis of long bones is presented.

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[18F]FDG PET/CT Imaging Is Associated with Lower In-Hospital Mortality in Patients with Pyogenic Spondylodiscitis—A Registry-Based Analysis of 29,362 Cases

Lang,

Walter,

Heidemanns

et al. 2024

Antibiotics

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Background: While MRI is the primary diagnostic tool for the diagnosis of spondylodiscitis, the role of [18F]-fluorodeoxyglucose ([18F]FDG) PET/CT is gaining prominence. This study aimed to determine the frequency of [18F]FDG PET/CT usage and its impact on the in-hospital mortality rate in patients with spondylodiscitis, particularly in the geriatric population. Methods: We conducted a Germany-wide cross-sectional study from 2019 to 2021 using an open-access, Germany-wide database, analyzing cases with ICD-10 codes M46.2-, M46.3-, and M46.4- (‘Osteomyelitis of vertebrae’, ‘Infection of intervertebral disc (pyogenic)’, and ‘Discitis unspecified’). Diagnostic modalities were compared for their association with in-hospital mortality, with a focus on [18F]FDG PET/CT. Results: In total, 29,362 hospital admissions from 2019 to 2021 were analyzed. Of these, 60.1% were male and 39.9% were female, and 71.8% of the patients were aged 65 years and above. The overall in-hospital mortality rate was 6.5% for the entire cohort and 8.2% for the geriatric subgroup (p < 0.001). Contrast-enhanced (ce) MRI (48.1%) and native CT (39.4%) of the spine were the most frequently conducted diagnostic modalities. [18F]FDG PET/CT was performed in 2.7% of cases. CeCT was associated with increased in-hospital mortality (OR = 2.03, 95% CI: 1.90–2.17, p < 0.001). Cases with documented [18F]FDG PET/CT showed a lower frequency of in-hospital deaths (OR = 0.58, 95% CI: 0.18–0.50; p = 0.002). This finding was more pronounced in patients aged 65 and above (OR = 0.42, 95% CI: 0.27–0.65, p = 0.001). Conclusions: Despite its infrequent use, [18F]FDG PET/CT was associated with a lower in-hospital mortality rate in patients with spondylodiscitis, particularly in the geriatric cohort. This study is limited by only considering data on hospitalized patients and relying on the assumption of error-free coding. Further research is needed to optimize diagnostic approaches for spondylodiscitis.

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Osteomyelitis

Cited by 3 publications

References 52 publications

Impact of the Host-Microbiome on Osteomyelitis Pathogenesis

Impact of the Host-Microbiome on Osteomyelitis Pathogenesis

Orthopaedic biofilm infections

[18F]FDG PET/CT Imaging Is Associated with Lower In-Hospital Mortality in Patients with Pyogenic Spondylodiscitis—A Registry-Based Analysis of 29,362 Cases

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