| Needle puncture and transcutaneous bone biopsy cultures are inconsistent in patients with diabetes and suspected osteomyelitis of the foot. | |
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MedLine Citation:
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PMID: 19228109 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Needle puncture has been suggested as a method for identifying bacteria in the bones in patients with diabetes with osteomyelitis of the foot. However, no studies have compared needle puncture with concomitant transcutaneous bone biopsy, which is the current standard recommended in international guidelines. METHODS: We conducted a prospective study in 2 French diabetes foot clinics. Transcutaneous bone biopsy specimens, needle puncture specimens, and swab samples were collected on the same day for each patient. RESULTS: Overall, 31 patients were included in the study from July 2006 through February 2008. Twenty-one bone biopsy specimens (67.7%), 18 needle puncture specimens (58%), and 30 swab samples (96.7%) had positive culture results. Staphylococcus aureus was the most common type of bacteria that grew from bone samples, followed by Proteus mirabilis and Morganella morganii. The mean number of bacteria types per positive sample were 1.35, 1.32, and 2.51 for bone biopsy specimens, needle puncture specimens, and swab samples, respectively. Among the 20 patients with positive bone biopsy specimens (69%), 13 had positive needle puncture samples. Overall, the correlation between microbiological results was 23.9%, with S. aureus showing the strongest correlation (46.7%). Results of cultures of bone biopsy and needle puncture specimens were identical for 10 (32.3%) of 31 patients. Bone bacteria were isolated from the needle punctures in 7 (33.3%) of the 21 patients who had positive bone biopsy specimen culture results. If the results of cultures of needle puncture specimens alone had been considered, 5 patients (16.1%) would have received unnecessary treatment, and 8 patients (38.1%) who had positive bone culture results would not have been treated at all. CONCLUSIONS:Our results suggest that needle punctures, compared with transcutaneous bone biopsies, do not identify bone bacteria reliably in patients with diabetes who have low-grade infection of the foot and suspected osteomyelitis. |
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Authors:
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Eric Senneville; Hélène Morant; Dominique Descamps; Sophie Dekeyser; Eric Beltrand; Bruno Singer; Michèle Caillaux; Arnaud Boulogne; Laurence Legout; Xavier Lemaire; Christine Lemaire; Yazdan Yazdanpanah |
Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article |
Journal Detail:
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Title: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Volume: 48 ISSN: 1537-6591 ISO Abbreviation: Clin. Infect. Dis. Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-09 Completed Date: 2009-04-13 Revised Date: 2009-09-01 |
Medline Journal Info:
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Nlm Unique ID: 9203213 Medline TA: Clin Infect Dis Country: United States |
Other Details:
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Languages: eng Pagination: 888-93 Citation Subset: IM |
Affiliation:
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Diabetic Foot Clinic, Gustave Dron Hospital, Tourcoing, France. esenneville@ch-tourcoing.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Bacterial Infections
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microbiology* Biopsy / methods* Diabetes Mellitus* Diabetic Foot / microbiology* France Humans Middle Aged Morganella morganii / isolation & purification Osteomyelitis / microbiology* Prospective Studies Proteus mirabilis / isolation & purification Sensitivity and Specificity Staphylococcus aureus / isolation & purification |
| Comments/Corrections | |
Erratum In:
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Clin Infect Dis. 2009 Aug 1;49(3):489 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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