The microbiology of chronic osteomyelitis: Changes over ten years.
J Infect
; 79(3): 189-198, 2019 09.
Article
en En
| MEDLINE
| ID: mdl-31319142
ABSTRACT
AIM:
This study quantified changes in the microbiology of osteomyelitis over a ten year period from a single centre within the UK with regard to infection with multi-drug resistant (MDR) bacteria and susceptibility of antimicrobial regimens.METHOD:
Patients with chronic osteomyelitis undergoing definitive surgery from 2013-2017 were inluded (nâ¯=â¯223). Microbiology was compared to patients in a cohort from 2001-2004, using the same diagnostic criteria, and same deep tissue sampling technique (nâ¯=â¯157). Clinical features associated with MDR bacterial infection were analysed using logistic regression.RESULTS:
Both cohorts had similar baseline characteristics. Despite a similar proportion of Staphylococcus aureus in both cohorts, the rate of methicillin resistant Staphylococcus aureus (MRSA) infection was lower in 2013-2017 compared to 2001-2004 (11.4% vs 30.8% of Staphylococcus aureus, pâ¯=â¯0.007). However, the proportion of MDR infections was similar in both cohorts (15.2% versus 17.2%). Metalwork was associated with MDR infection (unadjusted OR 5.0; 95% CI 1.15 to 22.0). There was no change in resistance to glycopeptide / meropenem combination treatment (2.2% vs 2.5%, p > 0.9).CONCLUSIONS:
In this centre, rates of MRSA osteomyelitis have fallen by two thirds, over the past 10 years, in line with the reducing rate of MRSA bacteraemia nationally. A history of metalwork may predict MDR infection. A glycopeptide with an anti-pseudomonal carbapenem remains the post-operative empiric systemic regimen of choice. Resistance patterns support the use of a glycopeptide with an aminoglycoside in local antibiotic therapy.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Osteomielitis
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Infecciones Bacterianas
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Infect
Año:
2019
Tipo del documento:
Article
País de afiliación:
Reino Unido