The microbiology of chronic osteomyelitis: prevalence of resistance to common empirical anti-microbial regimens.
OBJECTIVE
This study describes the microbiological spectrum of chronic osteomyelitis and so guides the choice of empirical antibiotics for this condition.


METHODS
We performed a prospective review of a 166 prospective patient series of chronic osteomyelitis from Oxford, UK in which a standardised surgical sampling protocol was used.


RESULTS
Staphylococcus aureus was most commonly isolated (32%) amongst a wide range of organisms including gram negative bacilli, anaerobes and coagulase negative staphylococci. Low grade pathogens were not confined to patients with a history of metalwork, a high proportion of cases were polymicrobial (29%) and culture negative cases were common (28%). No clear predictors of causative organism could be established. Many isolates were found to be resistant to commonly used empirical anti-microbial regimens.


CONCLUSIONS
The wide range of causative organisms and degree of resistance to commonly used anti-microbials supports the importance of extensive intra-operative sampling and provides important information to guide clinicians' choice of empirical antibiotics.
Department of Microbiology & Infectious Diseases, Oxford Radcliffe Hospitals' Trust, Oxford, UK. susannesheehy@doctors.org.uk
S H
SH
Sheehy
B A
BA
Atkins
P
P
Bejon
I
I
Byren
D
D
Wyllie
N A
NA
Athanasou
A R
AR
Berendt
M A
MA
McNally
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001419:Bacteria / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology*; D002908:Chronic Disease / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000382:microbiology*; D015995:Prevalence; D011446:Prospective Studies; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
D000900:Anti-Bacterial Agents