Program Schedule

702
A Bone of Contention for Culture Selection

Session: Poster Abstract Session: Approach to Clinical Infections
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • ID Week Poster FINAL.pdf (471.1 kB)
  • Background:  Osteomyelitis (OM) is a serious infection with high morbidity that poses a significant clinical challenge. Diagnostic tests have varying sensitivity and specificity, and treatment is often prolonged with combination therapy. Many factors play a role in the choice of antibiotic therapy, and how much bone culture results contribute to management is an unsettled issue.

    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.

    Results:

    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.

    Sameer Avasarala, MD1, Anee Khan, MSIII2, Daniela Moreno, B.S.3, Marcus J. Zervos, MD2,4 and Katherine C. Reyes, MD5, (1)Internal Medicine, Henry Ford Hospital, Detroit, MI, (2)Wayne State University School of Medicine, Detroit, MI, (3)Henry Ford Health System, Detroit, MI, (4)Division of Infectious Diseases, Henry Ford Hospital, Detroit, MI, (5)Infectious Disease, Henry Ford Health System, Detroit, MI

    Disclosures:

    S. Avasarala, None

    A. Khan, None

    D. Moreno, None

    M. J. Zervos, Pfizer: Grant Investigator, Research grant
    Forrest: Grant Investigator, Research grant

    K. C. Reyes, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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