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Title

Predicting the pathogen of diabetic toe osteomyelitis by two consecutive ulcer cultures with bone contact

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Published in European Journal of Clinical Microbiology & Infectious Diseases. 2011, vol. 30, no. 2, p. 279-81
Abstract In this study, we investigate the accuracy of two consecutive ulcer cultures with bone contact compared to bone biopsy for the diagnosis of diabetic toe osteomyelitis. The same nurse and orthopaedic surgeon obtained all samples: sample A-1: bone contact swabbing through the ulcer; sample A-2: a second culture swabbing from the bone surface within 24 h; sample B: surgical bone biopsy in the operating theatre. The kappa statistic measure between samples A-1 and A-2 (bone contact swabs) indicated 82.35% agreement. The sensitivity, specificity, positive and negative predictive values of the two samples A compared to B were 96%, 79%, 92% and 88%, respectively, for the causative pathogen. These results were similar with prior antibiotic treatment, discordant bone surface swabs or with monomicrobial infections. As a conclusion, two consecutive diabetic toe cultures with bone contact accurately predict the pathogen of diabetic toe osteomyelitis in 90% of cases.
Keywords AgedBacterial Infections/diagnosisBacteriological Techniques/methodsBiopsyDiabetes Complications/microbiologyHumansOsteomyelitis/microbiologyPredictive Value of TestsSensitivity and SpecificitySkin Ulcer/microbiologySpecimen Handling/methodsToes/microbiology/pathology
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PMID: 20936491
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Research groups Chirurgie orthopédique et traumatologique (98)
Glycopeptide résistance (28)
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BERNARD, Louis et al. Predicting the pathogen of diabetic toe osteomyelitis by two consecutive ulcer cultures with bone contact. In: European Journal of Clinical Microbiology & Infectious Diseases, 2011, vol. 30, n° 2, p. 279-81. https://archive-ouverte.unige.ch/unige:24237

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Deposited on : 2012-11-28

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