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Concordance of bone culture and deep tissue culture during the operation of diabetic foot osteomyelitis and clinical characteristics of patients

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

To retrospectively analyze the concordance of bacterial culture between bone tissue and deep soft tissue in diabetic foot osteomyelitis (DFO) patients and clinical characteristics of patients.

Methods

This study collected samples from 155 patients with suspected DFO (who required amputation after clinical evaluation). Bacterial culture and drug susceptibility tests were performed on the patients’ deep soft tissue and bone tissue, and the consistency between the two was compared. In addition, the differences among DFO patients with different degrees of infection were compared classified by the PEDIS classifications.

Results

Among the 155 patients diagnosed with DFO, the positive rate of bone culture was 78.7% (122/155). This study cultured 162 strains, including 73 Gram-positive bacteria, 83 Gram-negative bacteria, and 6 fungi. Staphylococcus aureus (33 strains) was the most common bacteria. The overall agreement between bone culture and tissue culture was 42.8%, with Staphylococcus aureus and Enterobacteria having the best (64.3%) and least agreements (27.3%), respectively. The drug sensitivity results in bone culture showed that Staphylococcus aureus was the main Gram-positive bacteria. The bacteria were sensitive to linezolid and vancomycin. Proteus mirabilis was the main Gram-negative bacteria. These were more sensitive than biapenem and piperacillin/tazobactam. Fungi were more sensitive to voriconazole and itraconazole.

Conclusion

The culture results of deep soft tissues near the bone cannot accurately represent the true pathogen of DFO. For DFO patients, bone culture should be taken as much as possible, and appropriate antibiotics should be selected according to the drug susceptibility results.

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Data availability

The original contributions presented in the study are included in the article. Further inquiries can be directed to the corresponding author.

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Acknowledgements

The authors wish to thank the study participants for their cooperation and participation.

Funding

Henan Provincial People’s Hospital 23456 Talent Project (ZC23456081).

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Authors and Affiliations

  1. Department of Endocrinology, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, No. 7 Weiwu Road, Jinshui District, Zhengzhou, 450003, Henan, China

    Jiawen Liu, Linlin Liu, Zixin Cai & Huifeng Zhang

  2. Department of Endocrinology, People’s Hospital of Henan University, Henan Provincial People’s Hospital, Zhengzhou, 450003, China

    Yantao Li

Authors
  1. Jiawen Liu
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  2. Linlin Liu
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  4. Zixin Cai
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  5. Huifeng Zhang
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Contributions

HZ, conceptualization. JL and ZC, visualization. HZ, funding acquisition. JL, formal analysis. LL and YL, resources. JL, writing–original draft preparation. JL, ZC, writing–review and editing. HZ, supervision. All authors contributed to the article and approved the submitted version.

Corresponding author

Correspondence to Huifeng Zhang.

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Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Henan Provincial People’s Hospital (2022–33), and all patients signed informed consent.

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Liu, J., Liu, L., Li, Y. et al. Concordance of bone culture and deep tissue culture during the operation of diabetic foot osteomyelitis and clinical characteristics of patients. Eur J Trauma Emerg Surg 49, 2579–2588 (2023). https://doi.org/10.1007/s00068-023-02342-5

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  • DOI: https://doi.org/10.1007/s00068-023-02342-5

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