Bone Infections Involving Anaerobic Bacteria

Lewis, Robert P.; Sutter, Vera L.; Finegold, Sydney M.

doi:10.1097/00005792-197807000-00001

Cited by 152 publications

(63 citation statements)

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“…All were anaerobes included in the genera Anaerococcus (3 isolates), Peptoniphilus (1 isolate), Clostridium (2 isolates), and Prevotella (1 isolate). These data confirm that anaerobes are probably an underestimated cause of bone and joint infections, as previously suggested (21,34,53).…”

Section: Vol 44 2006 Molecular Diagnosis Of Osteoarticular Infectiosupporting

confidence: 90%

Analysis of 525 Samples To Determine the Usefulness of PCR Amplification and Sequencing of the 16S rRNA Gene for Diagnosis of Bone and Joint Infections

et al. 2006

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The 16S rRNA gene PCR in the diagnosis of bone and joint infections has not been systematically tested. Five hundred twenty-five bone and joint samples collected from 525 patients were cultured and submitted to 16S rRNA gene PCR detection of bacteria in parallel. The amplicons with mixed sequences were also cloned. When discordant results were observed, culture and PCR were performed once again. Bacteria were detected in 139 of 525 samples. Culture and 16S rRNA gene PCR yielded identical documentation in 475 samples. Discrepancies were linked to 13 false-positive culture results, 5 false-positive PCR results, 9 false-negative PCR results, 16 false-negative culture results, and 7 mixed infections. Cloning and sequencing of 16S rRNA gene amplicons in 6 of 8 patients with mixed infections identified 2 to 8 bacteria per sample. Rarely described human pathogens such as Alcaligenes faecalis, Comamonas terrigena, and 21 anaerobes were characterized. We also detected, by 16S rRNA gene PCR, four previously identified bacteria never reported in human infection, Alkanindiges illinoisensis, dehydroabietic acid-degrading bacterium DhA-73, unidentified Hailaer soda lake bacterium, and uncultured bacterium clone HuCa4. Seven organisms representing new potential species were also detected. PCR followed by cloning and sequencing may help to identify new pathogens involved in mixed bone infection.

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Section: Vol 44 2006 Molecular Diagnosis Of Osteoarticular Infectiosupporting

confidence: 90%

Analysis of 525 Samples To Determine the Usefulness of PCR Amplification and Sequencing of the 16S rRNA Gene for Diagnosis of Bone and Joint Infections

et al. 2006

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“…DISCUSSION Anaerobic bacteria may be etiological agents of human osteomyelitis (6,9). For those cases of osteomyelitis due to organisms susceptible to penicillin and other beta-lactam compounds, there are several antibiotics capable of reaching ANTIMICROB.…”

Section: Resultsmentioning

confidence: 99%

Comparative penetration of metronidazole, clindamycin, chloramphenicol, cefoxitin, ticarcillin, and moxalactam into bone

Summersgill¹,

Schupp²,

Raff³

1982

Antimicrob Agents Chemother

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The concentrations of metronidazole, clindamycin, chloramphenicol, cefoxitin, ticarcillin, and moxalactam in the serum, femurs, and scapulae of normal rats were measured microbiologically 0.5, 1, 3, and 4 h after intravenous injection of 15-, 15-, 20-, 40-, 75-, and 30-mg/kg doses of the respective drugs. By 0.5 h metronidazole reached levels of 3.0 ,ug/g in compact femoral bone and 2.7 ,ug/g in cancellous scapular bone. Clindamycin and chloramphenicol reached levels of 8.1 and 6.1 pug/g, respectively, at 0.5 h. Cefoxitin penetrated bone to a level of 2.6 P,g/ g, whereas ticarcillin and moxalactam failed to reach significant levels in bone after single intravenous doses.Antibiotics with demonstrated in vitro and clinical effectiveness against anaerobic bacteria may be useful in the management of patients with osteomyelitis due to these organisms. Metronidazole, a compound with demonstrated effectiveness against anaerobic bacteria (4,7,8), has been shown to be successful in treating cases of anaerobic osteomyelitis (M. Raff, J. Melo, C. Chun, R. Varghese, and J. Summersgill, Prog. Abstr. Intersci. Conf. Antimicrob. Agents Chemother. 18th, Atlanta, Ga., abstr. no. 367, 1978). However, the extent to which this compound penetrates bone remains undetermined. This report compares the penetration of metronidazole, clindamycin, chloramphenicol, cefoxitin, ticarcillin, and moxalactam into the long and flat bones of normal rats. of maximum recommended dosages in milligrams per kilogram for humans. After injection with the appropriate antibiotic, groups of three animals in each series were decapitated with a guillotine at intervals of 0.5, 1, 2, 3, and 4 h. Blood was clotted at room temperature for 20 min, and serum was separated and stored at -40°C until assayed. Standards for determination of serum antibiotic concentration were prepared in pooled rat serum.The femurs and scapulae of each animal were excised and dissected free of soft tissue by aseptic techniques. Femurs were split lengthwise, and marrow was removed. Each bone specimen was washed for not more than 10 s in sterile saline to remove any remaining antibiotic-containing blood and tissue from the surface and stored at -40°C overnight. After removal from the freezer, bones were air-dried at room temperature for 1 h and fragmented with a presterilized steel mortar and pestle, and specimens from groups of three rats at each time interval were pooled for microbiological assay. Two milliliters of 0.1 M phosphate buffer (pH appropriate for antibiotic being assayed) was added to 1 g of bone powder. The resulting suspensions were assayed for antimicrobial activity. Standards were prepared by adding 2 ml of predetermined concentrations of antibiotic to 1 g of bone powder from untreated rats and assayed in parallel with the unknowns.Bone/serum ratios were calculated by dividing the bone concentrations (average offemur and scapula) by the average serum level at a particular time interval. Mean bone/serum ratios were then obtained by averaging the resulting bone/serum rat...

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“…Many investigators have regarded the sinus track as being unreliable for the isolation of pathogens in bone infection [1][2][3], but others have found this technique helpful [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis of bones and joints: diagnostic approaches

Mousa

1998

International Orthopaedics

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Bone Infections Involving Anaerobic Bacteria

Cited by 152 publications

References 0 publications

Analysis of 525 Samples To Determine the Usefulness of PCR Amplification and Sequencing of the 16S rRNA Gene for Diagnosis of Bone and Joint Infections

Analysis of 525 Samples To Determine the Usefulness of PCR Amplification and Sequencing of the 16S rRNA Gene for Diagnosis of Bone and Joint Infections

Comparative penetration of metronidazole, clindamycin, chloramphenicol, cefoxitin, ticarcillin, and moxalactam into bone

Tuberculosis of bones and joints: diagnostic approaches

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