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Identification of Prevotella in pedal osteomyelitis of a diabetic patient
Barbara J Dominiak1, William Oxberry, Patrick C Chen
1Department of Pathology, SUNY Downstate Medical Center, Brooklyn, New York 11222, USA.
Abstract:
Osteomyelitis in a diabetic patient with a nonhealing foot ulcer, multiple medical conditions, and recurrent hospitalization for antibiotic therapy was found to be associated with gram-negative bacteria Prevotella melanginoganica and Prevotella melaninoganica hemagglutinating variant. Those organisms were identified due to the morphologically distinct features in electron microscopy and sequencing of the genes after Polymerase chain reaction amplification from the pathological material. The bacteria invaded the bone and resided in osteocyte, osteoblast, and endothelial cells. The bacteria are usually associated with periodontal plaques, causing inflammation and destruction of gingival tissue and resorption of the alveolar bone. This is the first ultrastructural and molecular study of a diabetic bone lesion with anaerobic bacterial infection.
Insights
Diabetic foot ulcers can lead to serious bone infections. This study identifies Prevotella bacteria as a cause of osteomyelitis in diabetic patients, highlighting a novel anaerobic bacterial link.
Area of Science:
- Microbiology
- Infectious Diseases
- Diabetic Foot Complications
Background:
- Diabetic foot ulcers are a common complication, often leading to chronic infections like osteomyelitis.
- Recurrent hospitalizations for antibiotic therapy indicate challenges in treating these infections.
Observation:
- A diabetic patient with a nonhealing foot ulcer and multiple comorbidities presented with osteomyelitis.
- Electron microscopy and gene sequencing identified gram-negative bacteria, Prevotella melanginoganica and Prevotella melaninoganica hemagglutinating variant.
Findings:
- These anaerobic bacteria were found to invade bone tissue, residing within osteocytes, osteoblasts, and endothelial cells.
- The identified bacteria are typically associated with periodontal disease, not bone infections.
Implications:
- This research presents the first ultrastructural and molecular evidence of anaerobic bacterial infection in a diabetic bone lesion.
- Understanding this novel bacterial etiology could lead to improved diagnostic and therapeutic strategies for diabetic osteomyelitis.