1. Clinical characteristics and outcomes associated with culture-negative status in limb osteomyelitis patients.
- Author
-
Wu H, Wang X, Shen J, Wei Z, Wang S, Xu T, Luo F, and Xie Z
- Subjects
- Humans, Male, Female, Adult, Middle Aged, Retrospective Studies, Aged, Anti-Bacterial Agents therapeutic use, Treatment Outcome, Young Adult, Adolescent, Osteomyelitis microbiology, Osteomyelitis therapy, Debridement
- Abstract
Aims: This study aimed to investigate the clinical characteristics and outcomes associated with culture-negative limb osteomyelitis patients., Methods: A total of 1,047 limb osteomyelitis patients aged 18 years or older who underwent debridement and intraoperative culture at our clinic centre from 1 January 2011 to 31 December 2020 were included. Patient characteristics, infection eradication, and complications were analyzed between culture-negative and culture-positive cohorts., Results: Of these patients, 264 (25.2%) had negative cultures. Patients with a culture-negative compared with a culture-positive status were more likely to have the following characteristics: younger age (≤ 40 years) (113/264 (42.8%) vs 257/783 (32.8%); p = 0.004), a haematogenous aetiology (75/264 (28.4%) vs 150/783 (19.2%); p = 0.002), Cierny-Mader host A (79/264 (29.9%) vs 142/783 (18.1%); p < 0.001), antibiotic use before sampling (34/264 (12.9%) vs 41/783 (5.2%); p<0.001), fewer taken samples (n<3) (48/264 (18.2%) vs 60/783 (7.7%); p<0.001), and less frequent presentation with a sinus (156/264 (59.1%) vs 665/783 (84.9%); p < 0.001). After initial treatments of first-debridement and antimicrobial, infection eradication was inferior in culture-positive osteomyelitis patients, with a 2.24-fold increase (odds ratio 2.24 (95% confidence interval 1.42 to 3.52)) in the redebridement rate following multivariate analysis. No statistically significant differences were found in long-term recurrence and complications within the two-year follow-up., Conclusion: We identified several factors being associated with the culture-negative result in osteomyelitis patients. In addition, the data also indicate that culture negativity is a positive prognostic factor in early infection eradication. These results constitute the basis of optimizing clinical management and patient consultations., Competing Interests: The authors declare grants or contracts from National Natural Science Foundation of China (82202707), Chongqing Natural Science Foundation Program (CSTB2023NSCQ-BHX0202), Shanghai Natural Science Foundation Program (22ZR1476600), and Changning District Health Commission Fund (20234Y041), all of which are related to this study., (© 2024 The British Editorial Society of Bone & Joint Surgery.)
- Published
- 2024
- Full Text
- View/download PDF