A Bone of Contention for Culture Selection
Methods: A retrospective review of bone biopsy microbiology results from June 2013 to January 2014 was done at an 802-bed academic medical center. Only patients that had a bone culture performed for a clinical suspicion of OM based on radiographic studies were included in this study. Demographic information, comorbidities, co-existing microbiology results, and antibiotic selection were collected for each patient from their electronic medical record.
90 patients had bone biopsies performed for a clinical suspicion of OM. Patients had a mean age of 60.6 years ranging from 22 – 91 years and were predominantly male (63.3%, n=57). 65.5% (n=59) had positive bone biopsy culture results. Superficial wound cultures were performed on 48% (n=43) patients; 79% (n=34) of which were positive. A third of the patients (33%, n=30) had both positive bone biopsy and wound cultures, 16 (53%) of which grew identical organisms while 14 (47%) showed mixed flora, but had at least one organism identical to the bone biopsy culture. Antibiotic therapies were adjusted in 60% (n=54) of patients based on bone biopsy results.
Conclusion: The majority of our patients’ antibiotic coverage was altered following bone biopsy culture results. Bone biopsy proved to be critical in the therapeutic management of osteomyelitis. Further study is needed to complete comparative analysis for outcomes in patients whose treatment was affected by the bone biopsy vs. patients in which it was not.
D. Moreno, None
M. J. Zervos, Pfizer: Grant Investigator, Research grant
Forrest: Grant Investigator, Research grant
K. C. Reyes, None