%0 Journal Article
%T Clinical characteristics and outcomes associated with culture-negative status in limb osteomyelitis patients.
%A Wu H
%A Wang X
%A Shen J
%A Wei Z
%A Wang S
%A Xu T
%A Luo F
%A Xie Z
%J Bone Joint J
%V 106
%N 7
%D 2024 Jul 1
%M 38945537
%F 5.385
%R 10.1302/0301-620X.106B7.BJJ-2023-0778.R2
%X <B>UNASSIGNED: </B>This study aimed to investigate the clinical characteristics and outcomes associated with culture-negative limb osteomyelitis patients.<BR><B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>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.