Clinical characteristics and outcomes associated with culture-negative status in limb osteomyelitis patients.
Bone Joint J
; 106-B(7): 720-727, 2024 Jul 01.
Article
em En
| MEDLINE
| ID: mdl-38945537
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%); pï¼0.001), fewer taken samples (nï¼3) (48/264 (18.2%) vs 60/783 (7.7%); pï¼0.001), 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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Osteomielite
/
Desbridamento
Limite:
Adolescent
/
Adult
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Aged
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Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Bone Joint J
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
China