OBJECTIVES: The value of non-bone microbiological cultures in the diagnosis of osteomyelitis with sinus tract is not clear. We aimed to establish the concordance between deep sinus tract cultures and bone cultures in cases of osteomyelitis with a cutaneous fistula. METHODS: This was a non-randomized, prospective diagnostic trial at the Orthopedic Service of the University Hospital of Geneva. Each patient with osteomyelitis with a cutaneous sinus tract had four microbiological samples taken: two consecutive sinus tract cultures with bone contact at different times (samples A-1 and A-2), surgical bone biopsy performed through the sinus tract (sample B), and a surgical bone biopsy performed through an uninfected area outside the sinus tract (sample C), the latter considered as the 'gold standard'. RESULTS: One hundred and forty-one patients with 154 episodes of osteomyelitis were included in the study. When both sinus tract cultures yielded the same microorganism (86.4%), the concordance between both samples A and sample C was 96%. In the case of identical sinus tract culture infections, sensitivity was 91%, specificity 86%, and accuracy 90%. The accuracy in monomicrobial infections (50%) was higher than in polymicrobial infections (94.3% vs. 78.9%, respectively; p=0.02). CONCLUSIONS: In cases of monomicrobial osteomyelitis with sinus tract, two concordant tract cultures with bone contact accurately predict the pathogen. Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
OBJECTIVES: The value of non-bone microbiological cultures in the diagnosis of osteomyelitis with sinus tract is not clear. We aimed to establish the concordance between deep sinus tract cultures and bone cultures in cases of osteomyelitis with a cutaneous fistula. METHODS: This was a non-randomized, prospective diagnostic trial at the Orthopedic Service of the University Hospital of Geneva. Each patient with osteomyelitis with a cutaneous sinus tract had four microbiological samples taken: two consecutive sinus tract cultures with bone contact at different times (samples A-1 and A-2), surgical bone biopsy performed through the sinus tract (sample B), and a surgical bone biopsy performed through an uninfected area outside the sinus tract (sample C), the latter considered as the 'gold standard'. RESULTS: One hundred and forty-one patients with 154 episodes of osteomyelitis were included in the study. When both sinus tract cultures yielded the same microorganism (86.4%), the concordance between both samples A and sample C was 96%. In the case of identical sinus tract culture infections, sensitivity was 91%, specificity 86%, and accuracy 90%. The accuracy in monomicrobial infections (50%) was higher than in polymicrobial infections (94.3% vs. 78.9%, respectively; p=0.02). CONCLUSIONS: In cases of monomicrobial osteomyelitis with sinus tract, two concordant tract cultures with bone contact accurately predict the pathogen. Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Authors: Luca Maria Sconfienza; Alberto Signore; Victor Cassar-Pullicino; Maria Adriana Cataldo; Olivier Gheysens; Olivier Borens; Andrej Trampuz; Klaus Wörtler; Nicola Petrosillo; Heinz Winkler; Filip M H M Vanhoenacker; Paul C Jutte; Andor W J M Glaudemans Journal: Eur Radiol Date: 2019-06-27 Impact factor: 5.315
Authors: Lawrence A Lavery; P Andrew Crisologo; Javier La Fontaine; Kavitha Bhavan; Orhan K Oz; Kathryn E Davis Journal: J Foot Ankle Surg Date: 2019-07 Impact factor: 1.286
Authors: Andor W J M Glaudemans; Paul C Jutte; Maria Adriana Cataldo; Victor Cassar-Pullicino; Olivier Gheysens; Olivier Borens; Andrej Trampuz; Klaus Wörtler; Nicola Petrosillo; Heinz Winkler; Alberto Signore; Luca Maria Sconfienza Journal: Eur J Nucl Med Mol Imaging Date: 2019-01-24 Impact factor: 9.236