BACTERIAL AETIOLOGY OF OSTEOMYELITIS CASES AT FOUR HOSPITALS OF LAHORE

Faria Malik

Abstract


Background: The conclusive diagnosis of osteomyelitis requires isolation of pathogen in aspirate from bone lesion, bone debridement and blood culture. The present research was undertaken to study the microbiological pattern of cases of osteomyelitis reporting to four hospitals in Lahore. Method: One hundred and fifty patients of osteomyelitis were selected from outpatient departments and Orthopaedic wards of Lahore General Hospital, Sir Ganga Ram Hospital, Services Hospital and Mayo Hospital, Lahore. Specimens of pus from bone, blood and bone debridement were collected. All samples were inoculated onto two Blood Agar and one MacConkey agar plates. One Blood Agar plate was incubated anaerobically for 48 hours and the other two plates aerobically for 24 hours. Smears were made from samples and stained by the Gram’s stain. The colonies obtained were processed according to the technique of Mackie and MacCartney.Results: The commonest isolates belonged to the Enterobacteriaceae (32.8%), followed by Staphylococcus aureus (29.5%), Pseudomonas aeruginosa (15.5%), anaerobes (2.6%) and miscellaneous (19.3%). Five (2.7%) anerobic bacteria were isolated. Anaerobic bacteria were peptostreptococci, peptococci and bacteroides either alone or as a mixed infection. Conclusion: The present study highlights the importance of microbiological examination of bone in cases of osteomyelitis. Different types of bacteria either alone or as a mixed infection could be the causative agent(s).

Key Words: Bacteria, Aerobes, Staphylococci, Enterobacteriaceae, Pseudomonas, Anaerobes, Osteomyelitis.


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References


Nade S. Acute haematogenous osteomyelitis in infancy and childhood. J Bone Joint Surg 1983;65B:109-19.

Bick EM. An experimental study on infectious osteomyelitis. In: Bick EM (ed). Classics of Orthopaedics. Philadelphia: JB Lippincott Company;1976:461-2.

Glover SC, Padfield C, McKendrick MW, Geddes AM, Dwyer NJP. Acute osteomyelitis in a district general hospital. Lancet 1982;1:609-11.

Willis RB, Rozencwaig R. Pediatric osteomyelitis masquerading as skeletal neoplasia. Orthop Clin North Am 1996;27(3):625-34.

Gale W, Scott R. Puncture wound of the foot? Persistent pain? Think of Pseudomonas aeroginosa osteomyelitis. Injury: the Br J Acci Surg 1991;22(5):427-8.

Court-brown CM, Keating JF, McQueen MM .Infection after Intramedullary nailing of the tibia. J Bone Joint Surgery 1992;74 B:770-4.

Khan G, Hussain A, Rehman M. Infection of the sternum and costal cartilages following median sternotomy: Report of 4 cases. JPMI 1997;11(2):224-9.

Boll KL, Jurik AG. Sternal osteomyelitis in drug addicts. J Bone Joint Surg 1990;72B:328-9.

Kak V, Chanderasekar PH. Bone and Joint infections in injection drug users. Infect Dis Clin North Am 2002;16(3):681-95.

Lobati F, Herndon B, Bamberger D. Osteomyelitis: aetiology, diagnosis, treatment and outcome in a public versus a private institution. Infection 2001;29(6):333-6.

Tuson CE, Hoffman EB, Mann MD. Isotope bone scanning for acute osteomyelitis and septic arthritis in children. J Bone Joint Surg 1994;76B:306-10.

Howard CB, Einhorn M, Dagan R, Nyska M. Ultrasound in diagnosis and management of acute haematogenous osteomyelitis in children. J Bone Joint Surg [Br] 1993;75B(1):79-82.

Mah ET, LeQuesne GW, Gent RJ, Paterson DC. Ultrasonic features of acute osteomyelitis in children. J Bone Joint Surg 1994;76B(6):969-74.

Onitsuka H. MRI of bones, joints, and soft tissue. Asian Med J 1995;38(9):502-8.

Warner WC Jr. Osteomyelitis. In: Crenshaw AH, Daugherty K, Curro C. (eds) Campbell's Operative Orthopaedics. 8th Ed. St. Louis: Mosby Year Book; 1992:131-50.

Alam SI, Khan KA, Ansari AM, Ahmed A. Etiological study of chronic osteomyelitis in Karachi [Letter]. J Pak Med Assoc 1991;41:24

Karamat KA, Butt T, Abbas G. Osteomyelitis-prevalence and susceptibility pattern of causative micro-organisms in Rawalpindi/Islamabad area. Pak J Pathol 1995;6(2):61-6.

Farooq U, Ahmad IF, Bacteriological studies in osteomyelitis at Faisalabad. J Pak Med Assoc 1988;38:43-7.

Karwowska A, Davies HD, Jadavji T. Epidemiology and outcome of osteomyelitis in the era of sequential intravenous–oral therapy. Pediatr Infect Dis J 1998;17(11):1021-6.

Alonge TO, Ogunlade SO, Fashina AN. Microbial isolates in chronic osteomyelitis—a guide to management. Afr J Med Sci 2002;31(2):167-9.

Baird D. Staphylococcus: Cluster-forming Gram-Positive cocci. In: Colllee JG, Fraser AG, Marimion BP, Sinnons A (eds). Mackie and Mecartney Practical Medical Microbiology. 14th Ed. London: Churchill Livingstone; 1996:245-61.

Dendrinos GK, Kontos S, Lyritsis E. Use of the Ilizarov technique for treatment of non-union of the tibia associated with infection. J Bone Joint Surg 1995;77A(6):835-46.

Mousa HAL. Evaluation of sinus-track cultures in chronic bone infection. J Bone Joint Surg 1997;79B(4):567-9.

McNally MA, Small JO, Tofighi HG, Mollan RAB. Two-stage management of chronic osteomyelitis of the long bones: The Belfast technique. J Bone Joint Surg [Br] 1993;75B(3):375-80.

Marsh DR, Shah S, Elliott J, Kurdy N. The Ilizarov method in nonunion, malunion and infection of fractures. J Bone Joint Surg [Br] 1997;79B(2):273-9.

West WF, Kelly PJ, Martin WJ. Chronic osteomyelitis: I. Factors affecting the results of treatment in 186 patients. JAMA 1970;213(11):1837-42.

Kelly PJ, Martin WJ, Coventry MB. Chronic osteomyelitis. II. Treatment with closed irrigation and suction. JAMA 1970;213:1843-8.

Carek PJ, Dickerson LM, Sack JL, Diagnosis and management of osteomyelitis Am Fam Physician 2001;63:2413-20.

Gentry LO. Newer concepts in antimicrobial therapy. Clin Orthop Related Res 1990;261:23-6.

Ostermann PAW, Henry SL, Seligson D. The role of local antibiotic therapy in the management of compound fractures. Clin Orthop Related Res 1993;295:102-11.

Bukhari SAH, Skinner J, Bentley G. Management of delayed infection after total hip replacement (case report) Journal of Surgery Pakistan 2002;7:39–41.


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