Authors: L Bernard M Assal C Garzoni I Uçkay
Publish Date: 2010/10/10
Volume: 30, Issue: 2, Pages: 279-281
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 A1 bone contact swabbing through the ulcer sample A2 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 A1 and A2 bone contact swabs indicated 8235 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
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