Devascularized Bone Surface Culture: A Novel Strategy for Identifying Osteomyelitis-Related Pathogens

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Microbiology

Background:

• Osteomyelitis (OM) diagnosis relies on intraoperative tissue sampling culture (TSC), but its sensitivity is often insufficient.
• Accurate pathogen identification is crucial for effective OM treatment and management.
• There is a need for improved diagnostic methods to increase the positive detection rate of causative microorganisms.

Purpose of the Study:

• To evaluate the diagnostic efficiency of a novel devitalized bone surface culture (BSC) method for detecting OM pathogens.
• To compare the performance of BSC against the gold standard intraoperative tissue sampling culture (TSC).
• To assess the culture time and pathogen detection rates of both BSC and TSC.

Main Methods:

• A comparative study involving 51 patients diagnosed with OM between December 2021 and July 2022.
• Both devitalized bone surface culture (BSC) and intraoperative tissue sampling culture (TSC) were performed for bacterial identification.
• Data on pathogen detection rates, microorganism identification, and culture time were collected and analyzed.

Main Results:

• The positive detection rate for BSC (74.5%) was higher than for TSC (58.8%), although not statistically significant (p = 0.093).
• Both methods identified definite pathogens in 29 patients, showing concordance in results.
• BSC demonstrated a significantly shorter median culture time (1.0 days) compared to TSC (3.0 days) (p < 0.001).
• Staphylococcus aureus was the most frequently identified microorganism using the BSC method.

Conclusions:

• Devitalized bone surface culture (BSC) may offer a superior alternative to tissue sampling culture (TSC) for diagnosing osteomyelitis.
• BSC presents a higher detectable rate and a significantly reduced culture time, potentially improving clinical management.
• Further research is warranted to confirm the clinical utility and optimize the application of BSC in osteomyelitis diagnosis.