Abstract：
UNASSIGNED: This study aimed to investigate the clinical characteristics and outcomes associated with culture-negative limb osteomyelitis patients.
UNASSIGNED: A total of 1,047 limb osteomyelitis patients aged 18 years or older who underwent debridement and intraoperative culture at our clinic centre from 1 January 2011 to 31 December 2020 were included. Patient characteristics, infection eradication, and complications were analyzed between culture-negative and culture-positive cohorts.
UNASSIGNED: Of these patients, 264 (25.2%) had negative cultures. Patients with a culture-negative compared with a culture-positive status were more likely to have the following characteristics: younger age (≤ 40 years) (113/264 (42.8%) vs 257/783 (32.8%); p = 0.004), a haematogenous aetiology (75/264 (28.4%) vs 150/783 (19.2%); p = 0.002), Cierny-Mader host A (79/264 (29.9%) vs 142/783 (18.1%); p < 0.001), antibiotic use before sampling (34/264 (12.9%) vs 41/783 (5.2%); p＜0.001), fewer taken samples (n＜3) (48/264 (18.2%) vs 60/783 (7.7%); p＜0.001), and less frequent presentation with a sinus (156/264 (59.1%) vs 665/783 (84.9%); p < 0.001). After initial treatments of first-debridement and antimicrobial, infection eradication was inferior in culture-positive osteomyelitis patients, with a 2.24-fold increase (odds ratio 2.24 (95% confidence interval 1.42 to 3.52)) in the redebridement rate following multivariate analysis. No statistically significant differences were found in long-term recurrence and complications within the two-year follow-up.
UNASSIGNED: We identified several factors being associated with the culture-negative result in osteomyelitis patients. In addition, the data also indicate that culture negativity is a positive prognostic factor in early infection eradication. These results constitute the basis of optimizing clinical management and patient consultations.
UNASSIGNED: A total of 1,047 limb osteomyelitis patients aged 18 years or older who underwent debridement and intraoperative culture at our clinic centre from 1 January 2011 to 31 December 2020 were included. Patient characteristics, infection eradication, and complications were analyzed between culture-negative and culture-positive cohorts.
UNASSIGNED: Of these patients, 264 (25.2%) had negative cultures. Patients with a culture-negative compared with a culture-positive status were more likely to have the following characteristics: younger age (≤ 40 years) (113/264 (42.8%) vs 257/783 (32.8%); p = 0.004), a haematogenous aetiology (75/264 (28.4%) vs 150/783 (19.2%); p = 0.002), Cierny-Mader host A (79/264 (29.9%) vs 142/783 (18.1%); p < 0.001), antibiotic use before sampling (34/264 (12.9%) vs 41/783 (5.2%); p＜0.001), fewer taken samples (n＜3) (48/264 (18.2%) vs 60/783 (7.7%); p＜0.001), and less frequent presentation with a sinus (156/264 (59.1%) vs 665/783 (84.9%); p < 0.001). After initial treatments of first-debridement and antimicrobial, infection eradication was inferior in culture-positive osteomyelitis patients, with a 2.24-fold increase (odds ratio 2.24 (95% confidence interval 1.42 to 3.52)) in the redebridement rate following multivariate analysis. No statistically significant differences were found in long-term recurrence and complications within the two-year follow-up.
UNASSIGNED: We identified several factors being associated with the culture-negative result in osteomyelitis patients. In addition, the data also indicate that culture negativity is a positive prognostic factor in early infection eradication. These results constitute the basis of optimizing clinical management and patient consultations.
摘要：
■本研究旨在探讨培养阴性肢体骨髓炎患者的临床特征和预后。
■纳入了2011年1月1日至2020年12月31日在我们的临床中心接受清创和术中培养的1,047名年龄在18岁或以上的肢体骨髓炎患者。患者特征,根除感染，分析了文化阴性和文化阳性队列之间的并发症。
■在这些患者中，264（25.2％）有阴性培养。与培养阳性相比，培养阴性的患者更有可能具有以下特征：年龄较小（≤40岁）（113/264（42.8％）vs257/783（32.8％）；p=0.004），血源性病因（75/264（28.4%）对150/783（19.2%）；p=0.002），Cierny-Mader主机A（79/264（29.9％）对142/783（18.1％）；p<0.001），取样前使用抗生素(34/264(12.9%)vs41/783(5.2%)；p＜0.001)，采集样本较少（n＜3）（48/264（18.2%）vs60/783（7.7%）；p＜0.001），鼻窦表现频率较低(156/264(59.1%)vs665/783(84.9%);p<0.001)。经过首次清创和抗菌的初步治疗，培养阳性骨髓炎患者的感染根除率较差，多变量分析后，再清创率增加了2.24倍（比值比2.24（95％置信区间1.42至3.52））。在两年的随访中，长期复发和并发症的差异无统计学意义。
■我们确定了与骨髓炎患者的培养阴性结果相关的几个因素。此外,数据还表明，培养阴性是早期根除感染的积极预后因素。这些结果构成了优化临床管理和患者咨询的基础。
■纳入了2011年1月1日至2020年12月31日在我们的临床中心接受清创和术中培养的1,047名年龄在18岁或以上的肢体骨髓炎患者。患者特征,根除感染，分析了文化阴性和文化阳性队列之间的并发症。
■在这些患者中，264（25.2％）有阴性培养。与培养阳性相比，培养阴性的患者更有可能具有以下特征：年龄较小（≤40岁）（113/264（42.8％）vs257/783（32.8％）；p=0.004），血源性病因（75/264（28.4%）对150/783（19.2%）；p=0.002），Cierny-Mader主机A（79/264（29.9％）对142/783（18.1％）；p<0.001），取样前使用抗生素(34/264(12.9%)vs41/783(5.2%)；p＜0.001)，采集样本较少（n＜3）（48/264（18.2%）vs60/783（7.7%）；p＜0.001），鼻窦表现频率较低(156/264(59.1%)vs665/783(84.9%);p<0.001)。经过首次清创和抗菌的初步治疗，培养阳性骨髓炎患者的感染根除率较差，多变量分析后，再清创率增加了2.24倍（比值比2.24（95％置信区间1.42至3.52））。在两年的随访中，长期复发和并发症的差异无统计学意义。
■我们确定了与骨髓炎患者的培养阴性结果相关的几个因素。此外,数据还表明，培养阴性是早期根除感染的积极预后因素。这些结果构成了优化临床管理和患者咨询的基础。
