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A retrospective comparison of bone culture techniques
Jennifer A Kipp1, Lindsay K LeSavage2, Greg Russell3
1Wake Forest University School of Medicine, Podiatric Medicine and Surgery Resident - Department of Orthopaedic Surgery and Rehabilitation, Atrium Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
Summary
Bone swab cultures are more sensitive for diagnosing osteomyelitis than bone tissue cultures. Surgeons may consider using both methods for optimal microbiological analysis in bone infection cases.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Medical Microbiology
Background:
- The gold standard for diagnosing osteomyelitis is bone biopsy.
- IDSA 2023 guidelines recommend bone cultures for microbiological analysis.
- Optimal intraoperative bone sample collection methods remain debated.
Purpose of the Study:
- To retrospectively compare intraoperative bone swab cultures versus bone tissue cultures.
- Evaluate the diagnostic yield of two distinct bone culture techniques.
Main Methods:
- Retrospective review of 126 surgical procedures in 103 patients with suspected lower extremity osteomyelitis.
- Intraoperative collection of both bone swab and bone tissue cultures from the same site post-debridement or amputation.
- Microbiological analysis of all collected bone samples.
Main Results:
- Bone swab cultures showed higher positive results (40.5%) compared to bone tissue cultures (32%), p=0.027.
- Complete agreement between methods was observed in 80% of cases.
- Discrepancies favored positive results from bone swab cultures (p=0.028).
Conclusions:
- Bone swab cultures demonstrate superior sensitivity for detecting pathogens in osteomyelitis.
- Consideration of utilizing both bone swab and tissue cultures may enhance diagnostic accuracy.
- Findings support optimizing microbiological sampling in osteomyelitis management.
