Epidemiological, bacteriological and therapeutic aspects of chronic osteomyelitis in a sub-Saharan environment

The purpose of this study was to describe the epidemiological and bacterial aspects of chronic osteomyelitis at the regional hospital of Tenkodogo, in Burkina Faso. This prospective study took place at the regional hospital in Tenkodogo during the 3 year-period 2011-2013 and included all cases of chronic osteomyelitis diagnosed during those years. The diagnosis was based on clinical and radiological evidence. In all, 86 patients were identified, with a mean age of 18.5 years, and predominantly male (73 %). The mean time to consultation was 18 months. The most common sites of chronic osteomyelitis were the tibia and femur. Bacteriologically, the pathogen most frequently isolated was Staphylococcus (75.6 %). The pathogens isolated were mostly responsive to gentamicin (75 % of pathogens) and ciprofloxacin (56.2 % of pathogens). Resistance to the combination amoxicillin + clavulanic acid was observed frequently. The treatment included a sequestrectomy and additional long-term antibiotic therapy based on susceptibility testing. The recurrence rate was 5.8 % over a one-year follow-up. Encouraging results can be obtained in chronic osteomyelitis with proper treatment. In this perspective, the isolation of the causative organism and knowledge of its sensitivity to antibiotics are essential information.