The microbiology of chronic osteomyelitis: Prevalence of resistance to common empirical anti-microbial regimens
Accepted 10 March 2010. published online 29 March 2010.
Summary
Objectives
This study describes the microbiological spectrum of chronic osteomyelitis and so guides the choice of empirical antibiotics for this condition.
Methods
We performed a prospective review of a 166 prospective patient series of chronic osteomyelitis from Oxford, UK in which a standardised surgical sampling protocol was used.
Results
Staphylococcus aureus was most commonly isolated (32%) amongst a wide range of organisms including gram negative bacilli, anaerobes and coagulase negative staphylococci. Low grade pathogens were not confined to patients with a history of metalwork, a high proportion of cases were polymicrobial (29%) and culture negative cases were common (28%). No clear predictors of causative organism could be established. Many isolates were found to be resistant to commonly used empirical anti-microbial regimens.
Conclusions
The wide range of causative organisms and degree of resistance to commonly used anti-microbials supports the importance of extensive intra-operative sampling and provides important information to guide clinicians' choice of empirical antibiotics.
aDepartment of Microbiology & Infectious Diseases, Oxford Radcliffe Hospitals' Trust, Oxford, UK
bBone Infection Unit, Nuffield Orthopaedic Centre, Oxford, UK
cCentre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Oxford, UK
dThe Jenner Institute, University of Oxford, Oxford, UK
eDepartment of Histopathology, Nuffield Orthopaedic Centre, Oxford, UK
Corresponding author at: Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Old Road, Headington, Oxford, OX3 7LJ, UK. Tel.: +44 1865 857425; fax: +44 1865 857471.
ABSTRACT