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

Journal article

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.

Authors: Sheehy, S; Atkins, B; Bejon, P; Byren, I; Wyllie, D

• Publication status: Published
• Journal: Journal of infection
• Volume: 60
• Issue: 5
• Pages: 338-343
• Publication date: 2010-05-01
• DOI: 10.1016/j.jinf.2010.03.006
• EISSN: 1532-2742
• ISSN: 0163-4453
• Language: English
• Keywords: Young Adult; Adult; Great Britain; Aged; Prevalence; Humans; Drug Resistance, Bacterial; Chronic Disease; Bacteria; Middle Aged; Female; Aged, 80 and over; Prospective Studies; Adolescent; Bacterial Infections; Osteomyelitis; Male; Anti-Bacterial Agents