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Multidrug-resistant Gram-negative osteomyelitis: a 10-year study.

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    This study analyzed multi-drug resistant (MDR) and extensively-drug resistant (XDR) gram-negative osteomyelitis cases. Effective antimicrobial strategies combined with surgery are crucial for managing these challenging infections.

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    Area of Science:

    • Infectious Diseases
    • Orthopedic Surgery
    • Microbiology

    Background:

    • Osteomyelitis caused by multi-drug resistant (MDR) and extensively-drug resistant (XDR) gram-negative bacteria presents a significant clinical challenge.
    • Limited data exists on the management and outcomes of such infections.

    Purpose of the Study:

    • To investigate the causative organisms, surgical and medical management strategies, and outcomes of MDR and XDR gram-negative bacterial osteomyelitis.
    • To highlight the importance of antimicrobial stewardship in treating resistant infections.

    Main Methods:

    • Retrospective evaluation of 14 patients with acute osteomyelitis caused by MDR or XDR gram-negative pathogens treated between 2007 and 2016.
    • Analysis of causative pathogens, patient demographics, comorbidities, treatment regimens, and outcomes.

    Main Results:

    • Common pathogens included Acinetobacter baumanii, Klebsiella pneumoniae, Enterobacter cloacae, Escherichia coli, and Pseudomonas aeruginosa.
    • Most infections were hospital-acquired; comorbidities like smoking, diabetes, and injury were prevalent.
    • All patients received empirical combination antimicrobial treatment, with 13 undergoing surgical intervention.

    Conclusions:

    • Antimicrobial therapy is a vital adjunct to surgical treatment for acute osteomyelitis.
    • Strict adherence to antimicrobial strategies is paramount due to the increasing prevalence of resistant microorganisms.