BMC Infectious Diseases (May 2002)

Lack of microbiological concordance between bone and non-bone specimens in chronic osteomyelitis: an observational study

  • Vesga Omar,
  • Jaimes Fabián,
  • Galvis Wilson,
  • Zuluaga Andrés F

DOI
https://doi.org/10.1186/1471-2334-2-8
Journal volume & issue
Vol. 2, no. 1
p. 8

Abstract

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Abstract Background Prognosis of chronic osteomyelitis depends heavily on proper identification and treatment of the bone-infecting organism. Current knowledge on selecting the best specimen for culture is confusing, and many consider that non-bone specimens are suitable to replace bone cultures. This paper compares the microbiology of non-bone specimens with bone cultures, taking the last as the diagnostic gold standard. Methods Retrospective observational analysis of 50 patients with bacterial chronic osteomyelitis in a 750-bed University-based hospital. Results Concordance between both specimens for all etiologic agents was 28%, for Staphylococcus aureus 38%, and for organisms other than S. aureus 19%. The culture of non-bone specimens to identify the causative organisms in chronic osteomyelitis produced 52% false negatives and 36% false positives when compared against bone cultures. Conclusions Diagnosis and therapy of chronic osteomyelitis cannot be guided by cultures of non-bone specimens because their microbiology is substantially different to the microbiology of the bone.