Journal of Infection
Volume 60, Issue 5 , Pages 338-343 , May 2010

The microbiology of chronic osteomyelitis: Prevalence of resistance to common empirical anti-microbial regimens

  • S.H. Sheehy

      Affiliations

    • Department of Microbiology & Infectious Diseases, Oxford Radcliffe Hospitals' Trust, Oxford, UK
    • Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford, UK
    • Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Oxford, UK
    • Corresponding Author InformationCorresponding 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.
    • ,
  • B.A. Atkins

      Affiliations

    • Department of Microbiology & Infectious Diseases, Oxford Radcliffe Hospitals' Trust, Oxford, UK
    • Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford, UK
    • ,
  • P. Bejon

      Affiliations

    • Department of Microbiology & Infectious Diseases, Oxford Radcliffe Hospitals' Trust, Oxford, UK
    • Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford, UK
    • ,
  • I. Byren

      Affiliations

    • Department of Microbiology & Infectious Diseases, Oxford Radcliffe Hospitals' Trust, Oxford, UK
    • Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford, UK
    • ,
  • D. Wyllie

      Affiliations

    • The Jenner Institute, University of Oxford, Oxford, UK
    • ,
  • N.A. Athanasou

      Affiliations

    • Department of Histopathology, Nuffield Orthopaedic Centre, Oxford, UK
    • ,
  • A.R. Berendt

      Affiliations

    • Department of Microbiology & Infectious Diseases, Oxford Radcliffe Hospitals' Trust, Oxford, UK
    • Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford, UK
    • ,
  • M.A. McNally

      Affiliations

    • Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford, UK

,Accepted 10 March 2010.

References 

  1. Lew DP, Waldvogel FA. Osteomyelitis. Lancet. 2004;364:369–379
  2. Trampuz A, Zimmerli W. Diagnosis and treatment of infections associated with fracture-fixation devices. Injury. 2006;37(Suppl. 2):S59–S66
  3. Tunney MM, Patrick S, Curran MD, Ramage G, Hanna D, Nixon JR, et al. Detection of prosthetic hip infection at revision arthroplasty by immunofluorescence microscopy and PCR amplification of the bacterial 16S rRNA gene. J Clin Microbiol. 1999;37:3281–3290
  4. Ciampolini J, Harding KG. Pathophysiology of chronic bacterial osteomyelitis. Why do antibiotics fail so often?. Postgrad Med J. 2000;76:479–483
  5. Jones ME, Karlowsky JA, Draghi DC, Thornsberry C, Sahm DF, Nathwani D. Antibiotic susceptibility of bacteria most commonly isolated from bone related infections: the role of cephalosporins in antimicrobial therapy. Int J Antimicrob Agents. 2004;23:240–246
  6. Berendt T, Byren I. Bone and joint infection. Clin Med. 2004;4:510–518
  7. Spangehl MJ, Masri BA, O'Connell JX, Duncan CP. Prospective analysis of preoperative and intraoperative investigations for the diagnosis of infection at the sites of two hundred and two revision total hip arthroplasties. J Bone Joint Surg Am. 1999;81:672–683
  8. Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med. 2004;351:1645–1654
  9. Atkins BL, Athanasou N, Deeks JJ, Crook DW, Simpson H, Peto TE, et al. Prospective evaluation of criteria for microbiological diagnosis of prosthetic-joint infection at revision arthroplasty. The OSIRIS Collaborative Study Group. J Clin Microbiol. 1998;36:2932–2939
  10. Simpson AH, Wood MK, Athanasou NA. Histological assessment of the presence or absence of infection in fracture non-union. Injury. 2002;33:151–155
  11. Waldvogel FA, Medoff G, Swartz MN. Osteomyelitis: a review of clinical features, therapeutic considerations and unusual aspects. N Engl J Med. 1970;282:198–206
  12. Fenollar F, Roux V, Stein A, Drancourt M, Raoult D. Analysis of 525 samples to determine the usefulness of PCR amplification and sequencing of the 16S rRNA gene for diagnosis of bone and joint infections. J Clin Microbiol. 2006;44:1018–1028
  13. Mackowiak PA, Jones SR, Smith JW. Diagnostic value of sinus-tract cultures in chronic osteomyelitis. JAMA. 1978;239:2772–2775
  14. Tice AD, Hoaglund PA, Shoultz DA. Outcomes of osteomyelitis among patients treated with outpatient parenteral antimicrobial therapy. Am J Med. 2003;114:723–728
  15. Trampuz A, Zimmerli W. Prosthetic joint infections: update in diagnosis and treatment. Swiss Med Wkly. 2005;135:243–251
  16. Trampuz A, Piper KE, Jacobson MJ, Hanssen AD, Unni KK, Osmon DR, et al. Sonication of removed hip and knee prostheses for diagnosis of infection. N Engl J Med. 2007;357:654–663
  17. Schafer P, Fink B, Sandow D, Margull A, Berger I, Frommelt L. Prolonged bacterial culture to identify late periprosthetic joint infection: a promising strategy. Clin Infect Dis. 2008;47:1403–1409
  18. Pandey R, Drakoulakis E, Athanasou NA. An assessment of the histological criteria used to diagnose infection in hip revision arthroplasty tissues. J Clin Pathol. 1999;52:118–123
  19. Pandey R, Berendt AR, Athanasou NA. Histological and microbiological findings in non-infected and infected revision arthroplasty tissues. The OSIRIS Collaborative Study Group. Oxford Skeletal Infection Research and Intervention Service. Arch Orthop Trauma Surg. 2000;120:570–574

PII: S0163-4453(10)00074-5

doi: 10.1016/j.jinf.2010.03.006

Journal of Infection
Volume 60, Issue 5 , Pages 338-343 , May 2010

Article Tools