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Bone infections involving anaerobic bacteria
Medicine
|July 1, 1978
Summary
Anaerobic bacteria are frequently involved in non-hematogenous osteomyelitis, particularly in adults. Early recognition and appropriate antibiotic treatment, such as parenteral penicillin, are crucial for managing these bone infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Orthopedic Surgery
Background:
- Osteomyelitis reviews often overlook the significant role of anaerobic bacteria in bone infections.
- Optimal anaerobic transport and culture techniques are lacking in prospective studies.
- Anaerobic infections are prevalent in non-hematogenous osteomyelitis, common in adults.
Purpose of the Study:
- To investigate the prevalence and significance of anaerobic bacteria in osteomyelitis.
- To highlight the underappreciated role of anaerobes in bone infections.
- To guide clinical suspicion and initial antibiotic management for anaerobic osteomyelitis.
Main Methods:
- Retrospective analysis of 58 osteomyelitis cases at Wadsworth VA Hospital (1973-1975).
- Evaluation of anaerobic culture techniques and specimen reliability.
- Review of existing literature on anaerobic bone infections.
Main Results:
- 39% of patients had infections involving anaerobes.
- Anaerobes were isolated from 81% of specimens cultured anaerobically and 90% of bone samples.
- Anaerobic bacteria were often part of a mixed flora; infections were non-hematogenous.
Conclusions:
- Anaerobes play a substantial role in osteomyelitis, especially non-hematogenous types.
- Clinical clues like foul odor and specific anatomical sites (calvarium, extremities) suggest anaerobic involvement.
- Parenteral penicillin is recommended for suspected anaerobic bone infections, with bone or abscess cultures being most reliable.