Informativeness of bone intraoperative culture for diagnose osteomyelitis in diabetic foot patients.

BACKGROUND: Diagnosis of osteomyelitis in diabetic foot patients is frequently not obvious due to similar clinical and X-ray signs of bone infection and Sharcot osteopathy, but it is very important because of opposite approach to treatment of these conditions. Today we do not have reliable parameter...

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Autores principales:	Vitaly O. Tsvetkov, Olga V. Kolovanova, Oxana E. Frolova, Tatiana A. Gusarova, Ludmila G. Ezhova
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2019
Materias:	diabetic foot osteomyelitis bacteriology Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/b8d338b210474e80b009b64be01755bd
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spelling	oai:doaj.org-article:b8d338b210474e80b009b64be01755bd2021-11-14T09:00:22ZInformativeness of bone intraoperative culture for diagnose osteomyelitis in diabetic foot patients.2072-03512072-037810.14341/DM10048https://doaj.org/article/b8d338b210474e80b009b64be01755bd2019-12-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/10048https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378BACKGROUND: Diagnosis of osteomyelitis in diabetic foot patients is frequently not obvious due to similar clinical and X-ray signs of bone infection and Sharcot osteopathy, but it is very important because of opposite approach to treatment of these conditions. Today we do not have reliable parameters to determine the devastation of bone infection and, therefore, the rational volume of bone resection and debridement. AIMS: To determine the diagnostic value of bone culture for osteomyelitis in diabetic foot patients. MATERIALS AND METHODS: 177 patients underwent surgery due to different forms of diabetic foot. In 131 of them clinical signs of osteomyelitis were revealed and this diagnosis was confirmed by histology. 46 patients with diabetes who underwent high-level amputation without bone infection formed the control group. Intraoperative bone cultures and histological samples were taken in all cases. RESULTS: We found similar microbial landscape in various forms of diabetic foot and in control group. The frequency of positive intraoperative cultures in patients without osteomyelitis was detected as 63%. The sensitivity of bone culture was counted as 86,3%, the specificity – as 37%, the accuracy – 73.5%. CONCLUSIONS: Our findings suggest that bone culture is not reliable sign of bone infection in diabetic foot patients due to its low specificity. In our judgment, the only way to determine rational level of bone resection is visual intraoperative assessment and clinical signs such as development of granulation tissue and wound healing.Vitaly O. TsvetkovOlga V. KolovanovaOxana E. FrolovaTatiana A. GusarovaLudmila G. EzhovaEndocrinology Research Centrearticlediabetic footosteomyelitisbacteriologyNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 22, Iss 5, Pp 428-435 (2019)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	diabetic foot osteomyelitis bacteriology Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	diabetic foot osteomyelitis bacteriology Nutritional diseases. Deficiency diseases RC620-627 Vitaly O. Tsvetkov Olga V. Kolovanova Oxana E. Frolova Tatiana A. Gusarova Ludmila G. Ezhova Informativeness of bone intraoperative culture for diagnose osteomyelitis in diabetic foot patients.
description	BACKGROUND: Diagnosis of osteomyelitis in diabetic foot patients is frequently not obvious due to similar clinical and X-ray signs of bone infection and Sharcot osteopathy, but it is very important because of opposite approach to treatment of these conditions. Today we do not have reliable parameters to determine the devastation of bone infection and, therefore, the rational volume of bone resection and debridement. AIMS: To determine the diagnostic value of bone culture for osteomyelitis in diabetic foot patients. MATERIALS AND METHODS: 177 patients underwent surgery due to different forms of diabetic foot. In 131 of them clinical signs of osteomyelitis were revealed and this diagnosis was confirmed by histology. 46 patients with diabetes who underwent high-level amputation without bone infection formed the control group. Intraoperative bone cultures and histological samples were taken in all cases. RESULTS: We found similar microbial landscape in various forms of diabetic foot and in control group. The frequency of positive intraoperative cultures in patients without osteomyelitis was detected as 63%. The sensitivity of bone culture was counted as 86,3%, the specificity – as 37%, the accuracy – 73.5%. CONCLUSIONS: Our findings suggest that bone culture is not reliable sign of bone infection in diabetic foot patients due to its low specificity. In our judgment, the only way to determine rational level of bone resection is visual intraoperative assessment and clinical signs such as development of granulation tissue and wound healing.
format	article
author	Vitaly O. Tsvetkov Olga V. Kolovanova Oxana E. Frolova Tatiana A. Gusarova Ludmila G. Ezhova
author_facet	Vitaly O. Tsvetkov Olga V. Kolovanova Oxana E. Frolova Tatiana A. Gusarova Ludmila G. Ezhova
author_sort	Vitaly O. Tsvetkov
title	Informativeness of bone intraoperative culture for diagnose osteomyelitis in diabetic foot patients.
title_short	Informativeness of bone intraoperative culture for diagnose osteomyelitis in diabetic foot patients.
title_full	Informativeness of bone intraoperative culture for diagnose osteomyelitis in diabetic foot patients.
title_fullStr	Informativeness of bone intraoperative culture for diagnose osteomyelitis in diabetic foot patients.
title_full_unstemmed	Informativeness of bone intraoperative culture for diagnose osteomyelitis in diabetic foot patients.
title_sort	informativeness of bone intraoperative culture for diagnose osteomyelitis in diabetic foot patients.
publisher	Endocrinology Research Centre
publishDate	2019
url	https://doaj.org/article/b8d338b210474e80b009b64be01755bd
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Informativeness of bone intraoperative culture for diagnose osteomyelitis in diabetic foot patients.

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