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

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.

                                            [
  "009:25"
]
                                        

                                            {
  "fn": "NIH",
  "@type": "vcard:Contact",
  "hasEmail": "mailto:info@nih.gov"
}
                                        

                                            [
  {
    "@type": "dcat:Distribution",
    "title": "Official Government Data Source",
    "mediaType": "text/html",
    "description": "Visit the original government dataset for complete information, documentation, and data access.",
    "downloadURL": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC115844/"
  }
]
                                        

                                            [
  "bone-infection",
  "diagnostic-accuracy",
  "nih",
  "osteomyelitis-microbiology",
  "specimen-culture"
]
                                        

                                            [
  "009:048"
]
                                        

                                            {
  "name": "National Institutes of Health",
  "@type": "org:Organization"
}
                                        

                                            [
  "NIH"
]