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Predicting the pathogen of diabetic toe osteomyelitis by two consecutive ulcer cultures with bone contact

Bernard, L. ; Assal, M. ; Garzoni, C. ; Uçkay, I.

In: European Journal of Clinical Microbiology & Infectious Diseases, 2011, vol. 30, no. 2, p. 279-281

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    Titre
    • Predicting the pathogen of diabetic toe osteomyelitis by two consecutive ulcer cultures with bone contact
    Auteur
    • Bernard, L.. Orthopaedic Surgery Service, Geneva University Hospitals, 4, Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland
    • Assal, M.. Orthopaedic Surgery Service, Geneva University Hospitals, 4, Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland
    • Garzoni, C.. Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
    • Uçkay, I.. Orthopaedic Surgery Service, Geneva University Hospitals, 4, Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Journal of Clinical Microbiology & Infectious Diseases, 2011, vol. 30, no. 2, p. 279-281. Springer-Verlag
    Autre version électronique
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:311001
    Summary
    In this study, we investigate the accuracy of two consecutive ulcer cultures with bone contact compared to bone biopsy for the diagnosis of diabetic toe osteomyelitis. The same nurse and orthopaedic surgeon obtained all samples: sample A-1: bone contact swabbing through the ulcer; sample A-2: a second culture swabbing from the bone surface within 24 h; sample B: surgical bone biopsy in the operating theatre. The kappa statistic measure between samples A-1 and A-2 (bone contact swabs) indicated 82.35% agreement. The sensitivity, specificity, positive and negative predictive values of the two samples A compared to B were 96%, 79%, 92% and 88%, respectively, for the causative pathogen. These results were similar with prior antibiotic treatment, discordant bone surface swabs or with monomicrobial infections. As a conclusion, two consecutive diabetic toe cultures with bone contact accurately predict the pathogen of diabetic toe osteomyelitis in 90% of cases