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Animal models of osteomyelitis. Knowledge, hypothesis, and speculation.
1Infectious Disease Section, Medical College of Georgia, Augusta.
Infectious Disease Clinics of North America
|September 1, 1990
Summary
Bone is naturally resistant to infection, but disruptions like fractures increase susceptibility. Staphylococci may bind to bone components, and osteoclast activity may influence infection spread, particularly in diabetic foot infections. Further research into diagnosis and treatment is needed.
Area of Science:
- Orthopedics
- Infectious Diseases
- Microbiology
Background:
- Bone possesses significant natural resistance to infection.
- Surgical interventions or trauma (e.g., fractures, prostheses) can dramatically lower the infectious dose required for bone infection.
- Staphylococcal bacteria may possess specific mechanisms for bone colonization.
Purpose of the Study:
- To review insights from animal models regarding bone infection.
- To explore factors influencing bone susceptibility to infection.
- To discuss diagnostic and therapeutic challenges in osteomyelitis.
Main Methods:
- Review of findings from various animal models of bone infection.
- Analysis of factors contributing to bacterial invasion and spread within bone tissue.
- Evaluation of diagnostic imaging and antimicrobial treatment strategies.
Main Results:
- Bone's resistance to infection is compromised by perturbations, allowing infection with significantly smaller bacterial inocula (1000-10,000 fold decrease).
- Staphylococci may exhibit tropism for bone components like cartilage or collagen.
- Osteoclast activity and hydroxyapatite resorption may correlate with osteomyelitis distribution, potentially linking it to factors like diabetic foot trauma and fractures.
Conclusions:
- Animal models provide valuable insights into osteomyelitis pathogenesis, mirroring clinical challenges.
- Diagnostic tools like gallium-67 and indium-111 labeled white blood cells warrant further investigation.
- Promising antimicrobial agents include clindamycin, rifampin, and quinolones, though prophylaxis requires more study.