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Tytuł pozycji:

Factors predictive of relapse in adult bacterial osteomyelitis of long bones.

Tytuł :
Factors predictive of relapse in adult bacterial osteomyelitis of long bones.
Autorzy :
Garcia Del Pozo E; Plastic Surgery Service, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, Spain.
Collazos J; Infectious Diseases Unit, Hospital de Galdácano, Galdacano, Vizcaya, Spain.
Carton JA; Infectious Diseases Unit, Hospital Universitario Central de Asturias (HUCA), Oviedo University School of Medicine, Oviedo, Spain.; Group of Translational Research in Infectious Diseases, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain.
Camporro D; Plastic Surgery Service, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, Spain.
Asensi V; Infectious Diseases Unit, Hospital Universitario Central de Asturias (HUCA), Oviedo University School of Medicine, Oviedo, Spain. .; Group of Translational Research in Infectious Diseases, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Asturias, Spain. .
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Źródło :
BMC infectious diseases [BMC Infect Dis] 2018 Dec 07; Vol. 18 (1), pp. 635. Date of Electronic Publication: 2018 Dec 07.
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Original Publication: London : BioMed Central, [2001-
MeSH Terms :
Bacterial Infections/*diagnosis
Bacterial Infections/*epidemiology
Osteomyelitis/*diagnosis
Osteomyelitis/*epidemiology
Adult ; Aged ; Anti-Bacterial Agents/therapeutic use ; Bacterial Infections/therapy ; Female ; Humans ; Male ; Middle Aged ; Osteomyelitis/microbiology ; Osteomyelitis/therapy ; Prognosis ; Recurrence ; Risk Factors ; Staphylococcus aureus/isolation & purification
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Contributed Indexing :
Keywords: Antibiotics; Debridement; Muscular flap; Osteomyelitis; Relapse; Severity factors
Substance Nomenclature :
0 (Anti-Bacterial Agents)
Entry Date(s) :
Date Created: 20181212 Date Completed: 20190128 Latest Revision: 20190128
Update Code :
20210623
PubMed Central ID :
PMC6286499
DOI :
10.1186/s12879-018-3550-6
PMID :
30526540
Czasopismo naukowe
Background: Osteomyelitis is a difficult-to-cure infection with a high relapse rate despite combined medical and surgical therapies. Some severity factors, duration of antimicrobial therapy and type of surgical procedure might influence osteomyelitis relapse.
Methods: 116 patients with osteomyelitis were followed for ≥1 year after hospital discharge. Demographic, microbiological and clinical data, eight severity factors and treatment (surgical and antibiotic) were analyzed.
Results: Mean age was 53 years and 74.1% were men. Tibia (62.1%) and S. aureus (58.5%) were the most commonly involved bone and bacteria, respectively. Mean follow-up was 67.1 months. Forty-six patients underwent bone debridement, 61 debridement plus flap coverage and 9 antimicrobial therapy only. Twenty-six patients (22.4%) relapsed, at a mean of 11.2 months since hospital discharge. Duration > 3 months (p = 0.025), number of severity factors (P = 0.02) and absence of surgery (P = 0.004) were associated with osteomyelitis relapse in the univariate analysis. In the Cox regression analysis, osteomyelitis duration > 3 months (P = 0.012), bone exposure (P = 0.0003) and type of surgery (P < 0.0001) were associated with relapse. Regarding the surgical modalities, bone debridement with muscle flap was associated with better osteomyelitis outcomes, as compared with no surgery (P < 0.0001) and debridement only (P = 0.004).
Conclusions: Osteomyelitis extending for > 3 months, bone exposure and treatment other than surgical debridement with muscular flap are risk factors for osteomyelitis relapse.
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