INTRODUCTION: There has been increasing evidence in favor of conservative management of diabetic foot osteomyelitis which requires targeted antibiotic therapy to the causative pathogen. But the method of reliable microbiological isolation is controversial. AIMS AND OBJECTIVES: To study the concordance of superficial swab culture with bone biopsy specimen culture in patients with diabetic foot osteomyelitis. MATERIALS AND METHODS: A prospective study was conducted from July 2008 to July 2010. All consecutive patients with suspected diabetic foot osteomyelitis were included in the study. Superficial swab and Percutaneous bone biopsy specimens were obtained for culture. The culture results in these two groups were compared for concordance. RESULTS: A total of 144 patients were included in the study. 134 cases of bone biopsy specimen and 140 cases of superficial swab showed positive culture results. Mean number of isolate per sample was similar. Staphylococcus aureus was the commonest organism grown in both cultures. The bone pathogen was identified in the corresponding swab culture in only 55 cases (38.2%). Staphylococcus aureus had the highest concordance percentage of 46.5% which was not statistically significant. CONCLUSION: Superficial swab culture may not be accurate in identifying all the organisms causing diabetic foot osteomyelitis. Bone biopsy specimen taken simultaneously would increase the accuracy of detecting the bacterial isolate.
INTRODUCTION: There has been increasing evidence in favor of conservative management of diabetic foot osteomyelitis which requires targeted antibiotic therapy to the causative pathogen. But the method of reliable microbiological isolation is controversial. AIMS AND OBJECTIVES: To study the concordance of superficial swab culture with bone biopsy specimen culture in patients with diabetic foot osteomyelitis. MATERIALS AND METHODS: A prospective study was conducted from July 2008 to July 2010. All consecutive patients with suspected diabetic foot osteomyelitis were included in the study. Superficial swab and Percutaneous bone biopsy specimens were obtained for culture. The culture results in these two groups were compared for concordance. RESULTS: A total of 144 patients were included in the study. 134 cases of bone biopsy specimen and 140 cases of superficial swab showed positive culture results. Mean number of isolate per sample was similar. Staphylococcus aureus was the commonest organism grown in both cultures. The bone pathogen was identified in the corresponding swab culture in only 55 cases (38.2%). Staphylococcus aureus had the highest concordance percentage of 46.5% which was not statistically significant. CONCLUSION: Superficial swab culture may not be accurate in identifying all the organisms causing diabetic foot osteomyelitis. Bone biopsy specimen taken simultaneously would increase the accuracy of detecting the bacterial isolate.
Authors: Marcos C Schechter; Mohammed K Ali; Benjamin B Risk; Adam D Singer; Gabriel Santamarina; Hannah K Rogers; Ravi R Rajani; Guillermo Umpierrez; Maya Fayfman; Russell R Kempker Journal: Open Forum Infect Dis Date: 2020-08-29 Impact factor: 3.835
Authors: Brent Bernstein; Melody Stouder; Eric Bronfenbrenner; Steven Chen; David Anderson Journal: J Foot Ankle Res Date: 2017-08-25 Impact factor: 2.303