Lack of microbiological concordance between bone and non-bone specimens in chronic osteomyelitis: an observational study

Back round. Prognosis of chronic osteomyelitis depends heavily on proper identification and treatment of the bone-infecting organism. Current knowledge on selecting the best specimen or culture is con using, and many consider that non-bone specimens are suitable to replace bone cultures. This p per comp res the microbiology of non-bone specimens with bone cultures, taking the last as the diagnostic gold standard. Methods. Retrospective observation analysis of 50 patients with bacterial chronic osteomyelitis in 750-bed University-based hospital. Results. Concordance between both specimens or all etiologic gents was 28%, or Staphylococcus aureus 38%, and or organisms other than S. aureus 19%. The culture of non-bone specimens to identify the causative organisms in chronic osteomyelitis produced 52% false negatives and 36% false positives when comp red against bone cultures. Conclusions. Diagnosis and therapy of chronic osteomyelitis cannot be guided by cultures of non-bone specimens because their microbiology is substantially different to the microbiology of the bone.