Zapalenie kości i szpiku
Epidemiologia

Zapalenie kości i szpiku (osteomyelitis) to infekcja tkanki kostnej charakteryzująca się zapalnym niszczeniem i tworzeniem nowej kości. Roczna zapadalność w USA wynosi około 21,8/100 000 osobolat, z około 50 000 przypadków rocznie, a w Niemczech obserwuje się wzrost z 15,5 do 16,7/100 000 mieszkańców w latach 2008-2018. Zapadalność jest wyższa u dorosłych (~90/100 000) niż u dzieci (8,2-13/100 000), a w krajach rozwijających się, np. w Afryce Subsaharyjskiej, sięga 43-200/100 000. Wzrost częstości występowania obserwuje się zwłaszcza u osób powyżej 60. roku życia, co wiąże się m.in. z lepszą diagnostyką (MRI), wzrostem cukrzycy, starzeniem się populacji oraz wzrostem zakażeń szpitalnych i użycia narkotyków dożylnych. Zapalenie kości i szpiku dzieli się na krwiopochodne, przez ciągłość i po bezpośrednim zaszczepieniu, z różnym profilem epidemiologicznym i lokalizacją zmian (np. kość piszczelowa 31-35%, kość udowa, kręgosłup u dorosłych). Najczęstszym patogenem jest Staphylococcus aureus (60-80% przypadków), w tym MSSA i MRSA, a także bakterie Gram-ujemne i Kingella kingae u dzieci.

  1. Epidemiologia zapalenia kości i szpiku
    1. Częstotliwość występowania na świecie
    2. Trendy czasowe w epidemiologii
    3. Czynniki demograficzne
    4. Typy zapalenia kości i szpiku i ich epidemiologia
    5. Czynniki ryzyka i grupy wysokiego ryzyka
    6. Epidemiologia mikrobiologiczna
    7. Nadzór i monitorowanie zapalenia kości i szpiku
    8. Śmiertelność i chorobowość
    9. Obciążenie ekonomiczne i społeczne
  2. Wyzwania i perspektywy w nadzorze epidemiologicznym
    1. Wyzwania w zbieraniu danych
    2. Perspektywy i zalecenia
    3. Kolejne rozdziały

Epidemiologia zapalenia kości i szpiku

Zapalenie kości i szpiku (osteomyelitis) to poważna choroba infekcyjna dotycząca tkanki kostnej, charakteryzująca się postępującym zapalnym niszczeniem i tworzeniem nowej kości. Dokładna epidemiologia tego schorzenia nie jest w pełni poznana, a dostępne dane różnią się znacząco w zależności od regionu geograficznego, wieku populacji oraz uwzględnianych typów infekcji12.

Częstotliwość występowania na świecie

Ogólna roczna zapadalność na zapalenie kości i szpiku w Stanach Zjednoczonych wynosi około 21,8 przypadków na 100 000 osobolat31. Niektóre źródła podają, że choroba dotyka nawet 1 na 675 hospitalizacji rocznie w USA, co przekłada się na około 50 000 przypadków rocznie1. Z kolei w Niemczech odnotowano wzrost częstości występowania z 15,5 do 16,7 przypadków na 100 000 mieszkańców w latach 2008-2018, co stanowi wzrost o 10,44%4.

Badania epidemiologiczne wykazały znaczące różnice w zapadalności w zależności od wieku5:

  • U dzieci – około 8,2-13 przypadków na 100 00056
  • U dorosłych – około 90 przypadków na 100 0005

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Występowanie zapalenia kości i szpiku wykazuje istotne różnice geograficzne. W krajach rozwijających się zapadalność jest znacznie wyższa – w krajach Afryki Subsaharyjskiej wynosi ona 43-200/100 000, podczas gdy w krajach wysokorozwiniętych tylko 1,94-13/100 00078.

Trendy czasowe w epidemiologii

Obserwuje się wyraźny wzrost częstości występowania zapalenia kości i szpiku na przestrzeni ostatnich dekad. W badaniach prowadzonych w USA odnotowano wzrost zapadalności z 11,4 przypadków na 100 000 osobolat w latach 1969-1979 do 24,4 przypadków na 100 000 osobolat w latach 2000-200923. Ten trend wzrostowy obserwowany jest zwłaszcza w grupie pacjentów powyżej 60. roku życia, gdzie częstość niemal potroiła się w tym okresie9.

Wzrost częstości występowania zapalenia kości i szpiku może wynikać z różnych czynników, takich jak210:

  • Zmiany w sposobie diagnozowania i większa dostępność czułych badań obrazowych (np. MRI)
  • Wzrost występowania czynników ryzyka, zwłaszcza cukrzycy
  • Starzenie się populacji
  • Wzrost częstości występowania zakażeń szpitalnych związanych z urządzeniami wewnątrznaczyniowymi
  • Zwiększone użycie narkotyków dożylnych

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Interesująco, w przeciwieństwie do trendu ogólnego, niektóre badania wskazują na spadek częstości występowania ostrego krwiopochodnego zapalenia kości i szpiku u dzieci w krajach rozwiniętych. W Wielkiej Brytanii odnotowano znaczny spadek w populacji pediatrycznej, co może wynikać z poprawy warunków życia oraz wprowadzenia szczepień przeciwko Haemophilus influenzae11.

Czynniki demograficzne

Zapalenie kości i szpiku wykazuje charakterystyczny rozkład pod względem płci i wieku. Choroba występuje częściej u mężczyzn niż u kobiet, z proporcją wynoszącą od 1,2:1 do 3:1, przy czym przyczyny tej dysproporcji pozostają niewyjaśnione5121.

Wiek pacjentów również wpływa na epidemiologię zapalenia kości i szpiku15:

  • Krwiopochodne zapalenie kości i szpiku występuje najczęściej u dzieci i osób starszych
  • W populacji pediatrycznej najwyższa zapadalność występuje u dzieci w wieku 10-15 lat (15,3/100 000), a następnie w grupie 5-10 lat (9,7/100 000)6
  • Około jedna trzecia przypadków występuje u dzieci poniżej 2 roku życia, a około 50% u dzieci poniżej 5 roku życia13
  • U dorosłych zaobserwowano trend wzrostowy zachorowań w grupie 41-50 lat1415

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Typy zapalenia kości i szpiku i ich epidemiologia

Zapalenie kości i szpiku można klasyfikować w oparciu o różne kryteria, w tym drogę zakażenia, czas trwania oraz lokalizację anatomiczną. Każdy z typów charakteryzuje się odmiennym profilem epidemiologicznym16.

Zapalenie kości i szpiku według drogi zakażenia

Ze względu na drogę zakażenia wyróżniamy1716:

  1. Krwiopochodne zapalenie kości i szpiku (hematogenne) – wywołane przez rozprzestrzenianie się patogenów z odległych ognisk zakażenia drogą krwionośną:
    • Stanowi około 20% przypadków u dorosłych8
    • Częściej występuje u dzieci oraz osób starszych5
    • U dzieci najczęściej dotyczy kości długich
    • U dorosłych najczęściej dotyczy kręgosłupa18
  2. Zapalenie kości i szpiku przez ciągłość – wywołane przez rozprzestrzenianie się infekcji z sąsiednich tkanek:
    • Częściej występuje u dorosłych17
    • Często związane z ranami pourazowymi, owrzodzeniami stopy cukrzycowej lub infekcjami pooperacyjnymi12
    • Częstość występowania rośnie wraz ze wzrostem częstości cukrzycy i chorób naczyń obwodowych10
  3. Zapalenie kości i szpiku po bezpośrednim zaszczepieniu – spowodowane bezpośrednim wprowadzeniem patogenów do kości w wyniku urazu lub zabiegu chirurgicznego:
    • Częstość infekcji w ciągu trzech miesięcy po otwartym złamaniu wynosi do 27%19
    • Dotyczy najczęściej młodych dorosłych po urazach18

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Zapalenie kości i szpiku według czasu trwania

Pod względem czasu trwania wyróżniamy16:

  1. Ostre zapalenie kości i szpiku:
    • W populacji pediatrycznej w 2019 roku stanowiło 39,2% przypadków6
    • W Niemczech odnotowano wzrost występowania ostrego zapalenia kości i szpiku o 61,8% w ostatniej dekadzie20
  2. Przewlekłe zapalenie kości i szpiku:
    • W populacji pediatrycznej w 2019 roku stanowiło 38,4% przypadków, wzrastając o 38,7% w okresie obserwacji6
    • W Niemczech odnotowano wyższą liczbę przypadków przewlekłych w porównaniu do ostrych20
    • Badania wskazują na wzrost zachorowań na przewlekłe zapalenie kości i szpiku, co może wynikać ze wzrostu częstości występowania urazów komunikacyjnych oraz czynników ryzyka takich jak cukrzyca21

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Rozkład anatomiczny zapalenia kości i szpiku

Zapalenie kości i szpiku może dotyczyć różnych lokalizacji anatomicznych, a częstość występowania różni się w zależności od wieku i typu infekcji147:

  • Najczęściej zajęte kości to:
    • Piszczel (31-35% przypadków)7
    • Kość udowa (druga co do częstości)714
    • Kość piętowa (szczególnie po złamaniach zamkniętych tej kości)22
    • Kręgosłup (u dorosłych z krwiopochodnym zapaleniem kości i szpiku)23
  • U dzieci zapalenie kości i szpiku najczęściej dotyczy kości długich kończyn dolnych24
  • Szacowana częstość występowania zapalenia kości i szpiku kręgosłupa wynosiła 1 na 450 000 w 2001 roku, ale od tego czasu wzrosła8
  • Zapalenie kości łonowej stanowi rzadszą lokalizację, często związaną z infekcjami pooperacyjnymi25

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Czynniki ryzyka i grupy wysokiego ryzyka

Identyfikacja czynników ryzyka ma kluczowe znaczenie dla zapobiegania i wczesnego wykrywania zapalenia kości i szpiku. Do najważniejszych czynników ryzyka należą26217:

  • Cukrzyca – znacząco zwiększa ryzyko zapalenia kości i szpiku poprzez neuropatię obwodową, niedokrwienie i upośledzoną funkcję układu odpornościowego1021
  • Choroba naczyń obwodowych – ogranicza dopływ krwi do kończyn, zwiększając ryzyko infekcji i opóźniając gojenie21
  • Niedawny uraz – szczególnie złamania otwarte, które umożliwiają bezpośredni dostęp patogenów do kości2627
  • Zabiegi chirurgiczne dotyczące kości – w tym rekonstrukcje kostne lub wymiana stawów26
  • Dożylne stosowanie narkotyków – zwiększa ryzyko bakteriemii i krwiopochodnego zapalenia kości i szpiku278
  • Choroba sierpowatokrwinkowa – predysponuje do krwiopochodnego zapalenia kości i szpiku, zwłaszcza u dzieci2126
  • Hemodializa – zwiększa ryzyko bakteriemii26
  • Immunosupresja – w tym zakażenie HIV, szczególnie z liczbą limfocytów CD4 <100 komórek/mikroL28
  • Owrzodzenia Buruli – specyficzny czynnik ryzyka w krajach Afryki Subsaharyjskiej29

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Epidemiologia mikrobiologiczna

Profil mikrobiologiczny zapalenia kości i szpiku jest zróżnicowany i zależy od wieku pacjenta, drogi zakażenia oraz czynników ryzyka3031.

Najczęstsze patogeny związane z zapaleniem kości i szpiku to3129:

  • Staphylococcus aureus – odpowiada za 60-80% przypadków, będąc dominującym patogenem w zapaleniu kości i szpiku2930
    • W przypadku dzieci z ostrym krwiopochodnym zapaleniem kości i szpiku, S. aureus wrażliwy na metycylinę (MSSA) jest izolowany w około 40% przypadków z posiewów krwi i 79% z posiewów śródoperacyjnych32
    • Częstość występowania metycylinoopornego S. aureus (MRSA) różni się w zależności od regionu geograficznego3210
  • Bakterie Gram-ujemne – częściej występują w zapaleniu kości i szpiku związanym z urazami lub owrzodzeniami31
  • Kingella kingae – rosnąca częstość występowania u małych dzieci, prawdopodobnie związana z lepszą diagnostyką31
  • Prątki niegruźlicze (NTM) – rzadka przyczyna zapalenia kości i szpiku, częściej występująca u pacjentów z HIV3328
  • Grzyby – rzadka przyczyna zapalenia kości i szpiku, ale o rosnącym znaczeniu u pacjentów z immunosupresją3435

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Warto zauważyć, że charakter infekcji różni się w zależności od drogi zakażenia31:

  • Krwiopochodne zapalenie kości i szpiku jest zwykle monomikrobialne
  • Zapalenie kości i szpiku związane z owrzodzeniami jest zazwyczaj polimikrobialne31
  • W przypadku zapalenia kości łonowej, 44% przypadków stanowią infekcje polimikrobialne25

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Interesującym zjawiskiem jest to, że patogeny izolowane w przypadku nawrotu zapalenia kości i szpiku w tej samej kości różnią się od początkowej mikrobiologii w 86% przypadków31.

Nadzór i monitorowanie zapalenia kości i szpiku

Nadzór epidemiologiczny nad zapaleniem kości i szpiku stanowi wyzwanie ze względu na heterogenność choroby i brak standardowych systemów raportowania3637.

Systemy nadzoru epidemiologicznego napotykają następujące problemy3638:

  • Tradycyjne kryteria nadzoru mogą nie obejmować wszystkich przypadków, zwłaszcza gdy patogeny są izolowane z miejsc niesterylnych
  • Rozszerzone kryteria diagnozowania, uwzględniające izolację patogenów z miejsc niesterylnych, wykazują, że rzeczywista liczba przypadków może być wyższa niż raportowana36
  • Niedoszacowanie może prowadzić do niedostatecznych działań prewencyjnych u pacjentów z grup ryzyka38

3638

Dostępne dane epidemiologiczne pochodzą głównie z37:

  • Badań populacyjnych przeprowadzonych w wybranych regionach geograficznych
  • Badań szpitalnych, które mogą nie odzwierciedlać całej populacji
  • Systemów nadzoru chorób inwazyjnych, które mogą nie uwzględniać wszystkich przypadków zapalenia kości i szpiku

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W celu poprawy nadzoru nad zapaleniem kości i szpiku potrzebne są3839:

  • Standaryzowane definicje przypadków
  • Jednolite systemy raportowania
  • Uwzględnienie zarówno przypadków ostrych, jak i przewlekłych
  • Rozszerzone kryteria mikrobiologiczne, obejmujące zarówno infekcje monomikrobialne, jak i polimikrobialne

3839

Śmiertelność i chorobowość

Zapalenie kości i szpiku wiąże się ze znaczącą śmiertelnością i chorobowością4041:

  • Standaryzowany współczynnik śmiertelności dla pacjentów z zapaleniem kości i szpiku wynosi 2,73 (95% CI, 2,46-3,00), co wskazuje na co najmniej 2,5-krotnie zwiększone ryzyko zgonu40
  • Ogólna śmiertelność w przypadku grzybiczego zapalenia kości i szpiku wywołanego przez Aspergillus wynosi 25%35
  • Częstość nawrotów przewlekłego zapalenia kości i szpiku u dorosłych wynosi około 30% w ciągu 12 miesięcy19
  • W przypadku infekcji wywołanych przez Pseudomonas aeruginosa, wskaźnik nawrotów jest jeszcze wyższy, sięgając 50%19

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Powikłania zapalenia kości i szpiku obejmują41:

  • Ropnie (w kości lub tkankach miękkich)
  • Deformacje kostne
  • Zakażenie tkanek miękkich
  • Martwica kości
  • Złamania patologiczne
  • Septyczne zapalenie stawów
  • Tworzenie przetok
  • Rak płaskonabłonkowy (w miejscu przetoki)
  • Zakażenie ogólnoustrojowe

41

U dzieci zapalenie kości i szpiku wpływające na płytki wzrostowe kości długich może powodować zahamowanie wzrostu41.

Obciążenie ekonomiczne i społeczne

Zapalenie kości i szpiku stanowi znaczące obciążenie dla systemów opieki zdrowotnej oraz pacjentów2120:

  • W Ugandzie zapalenie kości i szpiku stanowi około 10% konsultacji ortopedycznych w przychodniach i 8% przyjęć pediatrycznych7
  • W Stanach Zjednoczonych zapalenie kości i szpiku jest przyczyną około 1% wszystkich hospitalizacji pediatrycznych13
  • Obciążenie finansowe związane z krwiopochodnym zapaleniem kości i szpiku jest zwykle niższe niż w przypadku zapalenia kości i szpiku związanego z urazami42
  • Rosnące rozpowszechnienie oporności na antybiotyki, zwłaszcza MRSA, komplikuje wybór antybiotyków i zwiększa koszty leczenia1043

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Dane na temat obciążenia społeczno-ekonomicznego zapalenia kości i szpiku w krajach Afryki Subsaharyjskiej są ograniczone, ale choroba nadal stanowi istotny problem zdrowia publicznego w tych regionach29.

Wyzwania i perspektywy w nadzorze epidemiologicznym

Epidemiologia zapalenia kości i szpiku stawia przed badaczami i systemami opieki zdrowotnej liczne wyzwania4445:

Wyzwania w zbieraniu danych

  • Heterogenność zapalenia kości i szpiku pod względem patogenezy, czasu trwania i lokalizacji utrudnia standaryzację danych epidemiologicznych46
  • Różne systemy klasyfikacji (np. Waldvogel, Cierny-Mader) mogą prowadzić do niespójności w raportowaniu przypadków16
  • Brak danych wysokiej jakości dotyczących zapalenia kości i szpiku, szczególnie w krajach rozwijających się29
  • Zróżnicowane metody diagnostyczne i kryteria włączenia w badaniach epidemiologicznych36

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Perspektywy i zalecenia

Aby poprawić nadzór epidemiologiczny nad zapaleniem kości i szpiku, zaleca się4748:

  • Opracowanie lokalnych wytycznych dotyczących zarządzania zapaleniem kości i szpiku, uwzględniających niezbędne badania, algorytmy leczenia oraz kryteria kliniczne47
  • Poprawa czułości diagnostycznej poprzez stosowanie nowoczesnych technik, takich jak badania molekularne (PCR) na próbkach ropy/biopsji24
  • Standaryzacja definicji przypadków i systemów raportowania49
  • Zwiększenie świadomości klinicznej, szczególnie wśród niespecjalistów, którzy mogą być pierwszymi osobami kontaktującymi się z pacjentami11
  • Multidyscyplinarne podejście, wymagające komunikacji i współpracy między ortopedami, radiologami, mikrobiologami, specjalistami chorób zakaźnych i pielęgniarkami44

4748

W przyszłości badania powinny skupić się na4450:

  • Patogenezie zapalenia kości i szpiku
  • Metodach leczenia, w tym nowych antybiotykach
  • Skuteczności bardziej agresywnych strategii chirurgicznych u pacjentów o wysokim ryzyku niepowodzenia leczenia
  • Badaniu czynników związanych z niepowodzeniem leczenia w większych kohortach pacjentów

4450

Poprawa nadzoru epidemiologicznego zapalenia kości i szpiku ma kluczowe znaczenie dla zrozumienia trendów chorobowych, optymalizacji protokołów diagnostycznych i terapeutycznych oraz lepszego przydzielania zasobów opieki zdrowotnej4820.

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Osteomyelitis – StatPearls – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK532250/
    The overall incidence of osteomyelitis in the United States is mostly unknown, but reports show it to be as high as 1 in 675 US hospital admissions each year or about 50,000 cases annually. […] Other studies show an overall incidence of osteomyelitis of 21.8 cases per 100,000 person-years. […] The incidence was higher in men for unknown reasons but increases with age, mainly due to an increase in the prevalence of comorbid factors such as diabetes mellitus and peripheral vascular disease. […] Also, an increase in the availability of sensitive imaging tests, such as magnetic resonance imaging (MRI) and bone scintigraphy has improved diagnostic accuracy and the ability to characterize the infection.
  • #2 Trends in the Epidemiology of Osteomyelitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4642868/
    The epidemiology of osteomyelitis in the United States is largely unknown. The purpose of this study was to determine long-term secular trends in the incidence of osteomyelitis in a population-based setting. […] The overall age and sex-adjusted annual incidence of osteomyelitis was 21.8 cases per 100,000 person-years. The annual incidence was higher for men than for women and increased with age (p 0.001). Rates increased with the calendar year (p 0.001) from 11.4 cases per 100,000 person-years in the period from 1969 to 1979 to 24.4 per 100,000 person-years in the period from 2000 to 2009. […] The reasons for the increase in osteomyelitis between 1969 and 2009 are unclear but could comprise a variety of factors, including changes in diagnosing patterns or increases in the prevalence of risk factors (e.g., diabetes) in this population.
  • #3 Trends in the Epidemiology of Osteomyelitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4642868/
    To date, however, there are only a handful of epidemiological studies of osteomyelitis in the U.S., and these studies are limited to selected subsets of patients, as defined by age, osteomyelitis type, anatomical location, or infecting organisms. […] The overall age and sex-adjusted annual incidence of osteomyelitis over the entire forty-one-year time period was 21.8 cases (95% CI, 20.2 to 23.4) per 100,000 person-years. […] Incidence rates increased significantly (p 0.001) over time. The overall age and sex-adjusted incidence was 11.4 cases per 100,000 person-years in the period from 1969 to 1979 and increased to 24.4 cases per 100,000 person-years in the period from 2000 to 2009. […] We observed an increase in incidence in all categories of osteomyelitis over time but most notably in diabetes-related cases and vertebral osteomyelitis.
  • #4 What is the burden of osteomyelitis in Germany? An analysis of inpatient data from 2008 through 2018 | BMC Infectious Diseases | Full Text
    https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06274-6
    The epidemiology of osteomyelitis in Germany is unknown, which makes it difficult to estimate future demands. […] Overall osteomyelitis prevalence increased by 10.44% from 15.5 to 16.7 cases per 100,000 inhabitants between 2008 through 2018. […] A trend towards more osteomyelitis diagnoses in older patients was observed. […] Osteomyelitis remains a serious problem for orthopedic and trauma surgery. […] In this population-based study trends in the epidemiology of osteomyelitis were described and prevalence was analyzed as a function of osteomyelitis subtype, anatomical localization, gender, and age group. […] It was demonstrated that the number of cases increased by 10.44% over the last decade up to 16.7 per 100,000 inhabitants in 2018. […] Our analysis also revealed that men were often affected than women, which is in accordance with findings by Kremers and colleagues reporting significantly lower incidences of 16.7 cases per 100,000 person-years for women compared to 27.7/100,000 for men.
  • #5 Osteomyelitis epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Osteomyelitis_epidemiology_and_demographics
    Incidence of osteomyelitis is approximately 13 per 100,000 in children and approximately 90 per 100,000 in adults. […] The annual incidence of pediatric osteomyelitis is approximately 13 per 100,000 individuals. […] The annual incidence in adult osteomyelitis is approximately 90 per 100,000 individuals. […] Hematogenous osteomyelitis occurs predominantly in children and elderly patients. […] Osteomyelitis occurs more commonly in males for unknown reasons. […] Osteomyelitis occurs equally among all races. […] Osteomyelitis is more common in developing countries.
  • #6 The Epidemiology of Osteomyelitis in Children
    https://www.mdpi.com/2227-9067/8/11/1000
    Pediatric osteomyelitis remains challenging to treat. Detailed epidemiological data are required to estimate future developments. Therefore, we aimed to analyze how the incidence has changed over the last decade depending on age, gender, osteomyelitis subtype, and anatomical localization. […] Incidence rates of osteomyelitis increased by 11.7% from 8.2 cases per 100,000 children in 2009 to 9.2 cases per 100,000 children in 2019. […] The age-specific incidence rate revealed the highest occurrence of osteomyelitis in patients aged 10–15 years (15.3/100,000 children), which increased by 23% over the observation period, followed by the age group 5–10 years (9.7/100,000 children). […] In 2019, out of all diagnoses, 39.2% were classified as acute, 38.4% as chronic, and 22.4% were unspecified, whereby chronic cases increased by 38.7%.
  • #7 Chronic osteomyelitis in Sub-Saharan Africa—A Review
    https://www.oatext.com/chronic-osteomyelitis-in-sub-saharan-africa-a-review.php
    The documented incidence of paediatric osteomyelitis in HICs is 1.94-13/100000 in contrast to reported incidence of 43-200/100000 reported in LICs globally, likely reflecting the higher incidence in Sub-Saharan Africa. […] The tibia (31-35%) remains the leading bone affected by COM while the femur ranks second. […] COM has reported to have its peak incidence in the second decade of life between 10-21 years of age, with a male to female ratio ranging to 1.2-2.7/1. […] Patients with chronic osteomyelitis mainly consult for continuous pus drainage or limb deformity; hence, they usually present to the outpatient Department. […] A hospital based multicentre study in Uganda reported COM to account near 10% of orthopaedic outpatient consults and 8% of paediatric admission. […] Sickle cell disease, peripheral vascular disease and diabetes mellitus are potential risk factors of COM in SSA and are known to be a global factor and often resulting into poly-microbial infections.
  • #8 Osteomyelitis: Practice Essentials, Anatomy, Pathophysiology
    https://emedicine.medscape.com/article/1348767-overview
    Approximately 20% of adult cases of osteomyelitis are hematogenous, which is more common in males for unknown reasons. […] The incidence of spinal osteomyelitis was estimated to be 1 in 450,000 in 2001. In subsequent years, however, the overall incidence of vertebral osteomyelitis is believed to have increased as a consequence of IV drug use, increasing age of the population, and higher rates of nosocomial infection due to intravascular devices and other instrumentation. […] The overall incidence of osteomyelitis is higher in developing countries.
  • #9
    https://journals.lww.com/jbjsjournal/fulltext/2015/05200/trends_in_the_epidemiology_of_osteomyelitis__a.7.aspx
    The epidemiology of osteomyelitis in the United States is largely unknown. The purpose of this study was to determine long-term secular trends in the incidence of osteomyelitis in a population-based setting. […] The overall age and sex-adjusted annual incidence of osteomyelitis was 21.8 cases per 100,000 person-years. The annual incidence was higher for men than for women and increased with age (p 0.001). Rates increased with the calendar year (p 0.001) from 11.4 cases per 100,000 person-years in the period from 1969 to 1979 to 24.4 per 100,000 person-years in the period from 2000 to 2009. […] The incidence remained relatively stable among children and young adults but almost tripled among individuals older than sixty years; this was partly driven by a significant increase in diabetes-related osteomyelitis from 2.3 cases per 100,000 person-years in the period from 1969 to 1979 to 7.6 cases per 100,000 person-years in the period from 2000 to 2009 (p 0.001). […] The reasons for the increase in osteomyelitis between 1969 and 2009 are unclear but could comprise a variety of factors, including changes in diagnosing patterns or increases in the prevalence of risk factors (e.g., diabetes) in this population.
  • #10 Diagnosis and Management of Osteomyelitis | AAFP
    https://www.aafp.org/pubs/afp/issues/2011/1101/p1027.html
    The incidence of chronic osteomyelitis is increasing because of the prevalence of predisposing conditions such as diabetes mellitus and peripheral vascular disease. […] The increased incidence of methicillin-resistant Staphylococcus aureus osteomyelitis complicates antibiotic selection. […] Chronic osteomyelitis from contiguous soft tissue infection is becoming more common because of the increasing prevalence of diabetic foot infections and peripheral vascular disease. […] These conditions may act synergistically to significantly increase the risk of osteomyelitis in these patients. […] The preferred diagnostic criterion for osteomyelitis is a positive bacterial culture from bone biopsy in the setting of bone necrosis. […] The diagnosis of osteomyelitis in adults can be difficult.
  • #11 CHANGING EPIDEMIOLOGY OF PAEDIATRIC OSTEOMYELITIS | Bone & Joint
    https://boneandjoint.org.uk/Article/10.1302/0301-620X.87BSUPP_III.0870270d
    Recent data from the UK suggests that the incidence of osteomyelitis in the paediatric population is declining. […] A marked reduction in osteomyelitis was noted over the twenty-four year incidence of the study. […] A marked fall in osteomyelitis has occurred in the paediatric population. This may be due to improved living conditions and the introduction of H Influenzae vaccinations. […] However, as osteomyelitis is becoming increasingly rare, a higher index of suspicion is required, particularly from non-specialists who are more likely to be the first to encounter these patients.
  • #12 Osteomyelitis | Radiology Reference Article | Radiopaedia.org
    https://radiopaedia.org/articles/osteomyelitis?embed_domain=external.radpair.com%2527%255B0%255Dfavicon.ico%2527%255B0%255Dfavicon.icofavicon.ico&lang=us
    Osteomyelitis can occur at any age. In those without specific risk factors, it is particularly common between the ages of 2-12 years and is more common in males (M:F of 3:1) 6. […] Osteomyelitis results from hematogenous spread, although direct extension from trauma and/or ulcers is relatively common (especially in the feet of diabetic patients).
  • #13 Osteomyelitis | 5-Minute Pediatric Consult
    https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617506/all/Osteomyelitis?q=Arthritis+Septic
    One of the most common invasive bacterial infections in children, accounting for 1% of all pediatric hospitalizations. […] One third occurs in children 2 years of age, and ~50% of cases occur in children 5 years of age. […] Boys are more commonly affected than girls (2:1 ratio).
  • #14 Epidemiology, microbiology and therapeutic consequences of chronic osteomyelitis in northern China: A retrospective analysis of 255 Patients | Scientific Reports
    https://www.nature.com/articles/s41598-018-33106-6
    The study aimed to explore the epidemiology and clinical characteristics of chronic osteomyelitis observed in a northern China hospital. […] Chronic osteomyelitis is more common in males and in the age group from 41-50 years of age. […] Common infection sites are the femur, tibiofibular, and hip joint. […] More g+ than g- bacterial infections were observed, with S. aureus the most commonly observed pathogenic organism. […] The positive detection rate from debridement bacterial culture is 75.6%. […] The detection rate when five samples are sent for bacterial culture is 90.6%, with pathogenic bacteria identified in 82.8% of cases. […] Wang and Jiang et al. provide recent data on the epidemiology of chronic osteomyelitis in southwest and southern China, which can be used by local government policy-makers and by clinicians. […] Currently, data and relevant research are lacking for northern China on the epidemiology of chronic osteomyelitis. […] The current study suggests a treatment of two stage debridement + antibiotic-loaded PMMA spacers external fixation is the most effective.
  • #15 Epidemiology, Microbiology and Therapeutic Consequences of Chronic Osteomyelitis in Northern China: A Retrospective Analysis of 255 Patients | bioRxiv
    https://www.biorxiv.org/content/10.1101/316836v1
    The study aimed to explore the epidemiology and clinical characteristics of chronic osteomyelitis observed in a northern China hospital. […] Clinical data of 255 patients with chronic osteomyelitis from January 2007 to January 2014 were collected and analyzed, including general information, disease data, treatment and follow-up data. […] Chronic osteomyelitis is more common in males and in the age group from 41-50 years of age. […] Common infection sites are the femur, tibiofibular, and hip joint. […] More g+ than g- bacterial infections were observed, with S. aureus the most commonly observed pathogenic organism. […] The positive detection rate from debridement bacterial culture is 75.6%. […] The detection rate when five samples are sent for bacterial culture is 90.6%, with pathogenic bacteria identified in 82.8% of cases.
  • #16 Diagnosis and Management of Osteomyelitis | AAFP
    https://www.aafp.org/pubs/afp/issues/2001/0615/p2413.html
    Acute osteomyelitis is the clinical term for a new infection in bone. This infection occurs predominantly in children and is often seeded hematogenously. In adults, osteomyelitis is usually a subacute or chronic infection that develops secondary to an open injury to bone and surrounding soft tissue. The specific organism isolated in bacterial osteomyelitis is often associated with the age of the patient or a common clinical scenario (i.e., trauma or recent surgery). […] Osteomyelitis is an inflammation of bone caused by a pyogenic organism. Historically, osteomyelitis has been categorized as acute, subacute or chronic, with the presentation of each type based on the time of disease onset (i.e., occurrence of infection or injury). […] Because osteomyelitis is a complex disease state, various classification systems have emerged beyond the general categories of acute, subacute and chronic. The Waldvogel classification system divides osteomyelitis into the categories of hematogenous, contiguous and chronic. The more recent Cierny-Mader staging system is based on the status of the disease process, not etiology, chronicity or other factors.
  • #17 Osteomyelitis – Knowledge @ AMBOSS
    https://www.amboss.com/us/knowledge/osteomyelitis/
    Osteomyelitis is an infection of the bone; it occurs following hematogenous (seeded from a remote source) or exogenous (expansion from nearby tissue) spread of pathogens, most commonly Staphylococcus aureus. […] Epidemiology: typically occurs in children of age (: 2:1) […] Incidence: 20 per 100,000. […] Hematogenous osteomyelitis: more common in children and adolescents. […] Incidence is increasing in adults, driven by a rise in vertebral osteomyelitis. […] Exogenous osteomyelitis: more common in adults.
  • #18 Osteomyelitis – Infectious Disease Advisor
    https://www.infectiousdiseaseadvisor.com/ddi/osteomyelitis/
    Data regarding the incidence of osteomyelitis are sparse. According to data from 2012, the condition affects 10.5 per 100,000 people aged 20 years or younger. Incidence in adults is estimated to be as high as 21.8 cases per 100,000 person-years. […] There are 3 main types of osteomyelitis: hematogenous osteomyelitis, due to bacteremia; contiguous osteomyelitis, due to spread from nearby tissue; and osteomyelitis, due to direct inoculation from trauma or surgery. Hematogenous osteomyelitis occurs more frequently in children, usually affecting the long bones. In adults, hematogenous osteomyelitis usually affects the vertebrae. […] Contiguous osteomyelitis is most commonly caused by trauma and trauma-related surgery in young adults, while in older adults it tends to occur due to infected decubitus ulcers or joint replacement. Diabetes also contributes to contiguous osteomyelitis by causing vascular insufficiency, peripheral neuropathy, and impaired immune function.
  • #19 Diagnosis and Management of Osteomyelitis | AAFP
    https://www.aafp.org/pubs/afp/issues/2011/1101/p1027.html
    Microbial cultures are essential in the diagnosis and treatment of osteomyelitis. […] The incidence of significant infection within three months after an open fracture has been reported to be as high as 27 percent. […] Despite the use of surgical debridement and long-term antibiotic therapy, the recurrence rate of chronic osteomyelitis in adults is about 30 percent at 12 months. […] Recurrence rates in cases involving P. aeruginosa are even higher, nearing 50 percent.
  • #20 What is the burden of osteomyelitis in Germany? An analysis of inpatient data from 2008 through 2018 | BMC Infectious Diseases | Full Text
    https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06274-6
    The observed trend towards more osteomyelitis diagnosis in older patients possibly reflects demographic changes such as population decline and aging, which challenge the healthcare system not only in Germany. […] Further, higher numbers of chronic cases compared to acute cases were determined, whereas the prevalence of acute osteomyelitis rose by 61.8%. […] Osteomyelitis remains a serious problem for orthopedic and trauma surgery, also for countries comparable with Germany.
  • #21 Chronic osteomyelitis in Sub-Saharan Africa—A Review
    https://www.oatext.com/chronic-osteomyelitis-in-sub-saharan-africa-a-review.php
    Chronic osteomyelitis (COM) has remained an orthopaedic clinical challenge for many decades. […] We conducted this study to understand the epidemiological and clinical features of COM in Sub-Saharan Africa (SSA). […] The incidence of COM in SSA is far greater than high income countries. […] Sickle cell disease, peripheral vascular disease, diabetes mellitus, Buluri ulcers and septicemia were reported as potential risk factors in SSA. […] COM remains on the rise in SSA. […] This trend is in line with the rise in exogenous osteomyelitis, road traffic injuries in addition to factors like patient characteristics, ignorance and poverty. […] The African and global research databases present a scarcity of data related to general consensus of chronic osteomyelitis in Sub-Saharan Africa.
  • #22 The epidemiology and clinical features of calcaneus osteomyelitis following calcaneus fracture: a retrospective study of 127 cases – Huang – Annals of Palliative Medicine
    https://apm.amegroups.org/article/view/65980/html
    To analyze the epidemiology and features of calcaneus osteomyelitis following open reduction and internal fixation (ORIF) after closed calcaneus fracture. […] We analyzed the epidemiology and identified the characteristics of calcaneus osteomyelitis following closed calcaneus fracture, and hoped to gain an understanding of its clinical features to develop the base of knowledge for treatment and prevention of calcaneus osteomyelitis. […] It is critical to prevent the occurrence of osteomyelitis proactively, thus leading us to retrospectively study 127 hospitalized patients diagnosed with calcaneus osteomyelitis following ORIF after closed calcaneus fracture (March 2016 to August 2019). […] Understanding the frequency, distribution, and clinical features of calcaneal osteomyelitis following calcaneus fracture may help to minimize the occurrence of osteomyelitis.
  • #23 OSTEOMYELITIS | Harrison’s Manual of Medicine
    https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623647/all/OSTEOMYELITIS
    Osteomyelitis cases can be classified by pathogenesis, duration of infection, location of infection, and whether prosthetic material is present. […] Hematogenous osteomyelitis in adults most commonly results in vertebral infection, with 6.5 cases/100,000 at ages 70 years.
  • #24 Epidemiology and Management of Acute Haematogenous Osteomyelitis in a Tertiary Paediatric Center
    https://www.mdpi.com/1660-4601/14/5/477
    Our study confirms epidemiological data previously well described in literature: AHOM is more commonly reported in males and in young children, it more frequently involves the lower limb and long bones, and the patient’s history is commonly positive for a recent trauma or a febrile episode. Microbiological identification of the causative pathogen in our dataset was consistent with previous results: a microorganism was identified in more than one third of cases. The sensitivity of blood and pus culture was 32.4% and 46.4%, respectively. The sensitivity of the PCR assay was only 3.6% on blood sample and reached 64.0% on pus/biopsy sample, underlying the importance of performing PCR assay on pus/biopsy specimens. […] Complications occur frequently in children with AHOM and are strongly related to S. aureus infection. In this study microbiological diagnosis was obtained in over one third of cases. Empiric treatment targeting methicillin-sensitive Staphylococcus aureus seems to be justified by available microbiological data.
  • #25 CRIOAc Lyon Pubic osteomyelitis: Epidemiology and factors associated with treatment failure
    https://www.crioac-lyon.fr/document/articlepubic-osteomyelitis-epidemiology-and-factors-associated-withtreatment-failure/
    To describe the epidemiology of pubic osteomyelitis (PO) and to look for factors associated with treatment failure. […] Twenty-five patients were included over a 13-year period; 24% of PO had blood-borne infection. […] Failure (44%) was always observed in chronic postoperative presentations (76%). […] Other risk factors were pelvic malignant tumor history, abscess, infection due to extended-spectrum beta-lactamase-producing Enterobacteriaceae, and polymicrobial infection. […] PO is most often a chronic postoperative polymicrobial infection in patients with comorbidities at high risk of relapse.
  • #26 Osteomyelitis – Infectious Disease Advisor
    https://www.infectiousdiseaseadvisor.com/ddi/osteomyelitis/
    Osteomyelitis can also be described using the Cierny-Mader staging system, which is based on the anatomic stage and physiologic health status of the patient. […] Systemic compromise of patient health status may be caused by diabetes, immunodeficiency, malnutrition, kidney or liver failure, and other systemic disease states. Local compromising factors of patient health consist of venous stasis, peripheral neuropathy, arteritis, chronic lymphedema, and other highly localized conditions. […] Risk factors for osteomyelitis include both acute and chronic conditions. Recent trauma affecting the bones, especially open fractures, or surgery affecting the bones, such as bone reconstruction or joint replacement surgery, increases the risk for osteomyelitis. Chronic conditions can increase osteomyelitis risk. These include diabetes (especially with foot ulcers), sickle cell disease, cardiovascular disease, rheumatoid arthritis, cancer, kidney or liver disease, and conditions that increase the risk for decubitus ulcers. Endocarditis, hemodialysis, intravenous drug use, and other conditions may also increase the risk for bacteremia and osteomyelitis.
  • #27
    https://www.orthobullets.com/trauma/1057/osteomyelitis–adult
    Osteomyelitis is the infection of bone characterized by progressive inflammatory destruction and apposition of new bone. […] the exact incidence is unknown […] spine and ribs in dialysis patients […] medial or lateral clavicle in IV drug abusers […] foot and decubitus ulcers in diabetics […] recent trauma or surgery […] immunocompromised patients […] illicit IV drug use […] poor vascular supply […] systemic conditions such as diabetes and sickle cell […] peripheral neuropathy.
  • #28 Epidemiology, clinical manifestations, and diagnosis of osteomyelitis due to nontuberculous mycobacteria – UpToDate
    https://www.uptodate.com/contents/epidemiology-clinical-manifestations-and-diagnosis-of-osteomyelitis-due-to-nontuberculous-mycobacteria/print
    NTM infections are commonly associated with HIV infection. Mycobacterium avium complex, Mycobacterium haemophilum, and Mycobacterium kansasii have been the most common pathogens reported in cases of HIV-associated NTM osteomyelitis, and usually occur in the setting of disseminated disease. Most cases have occurred in the setting of advanced AIDS and a CD4 count <100 cells/microL.
  • #29 Chronic osteomyelitis in Sub-Saharan Africa—A Review
    https://www.oatext.com/chronic-osteomyelitis-in-sub-saharan-africa-a-review.php
    Buruli ulcers are as well a distinct risk factor related to SSA COM. […] Staphylococcus Aureus at 60 to 80% (with higher level of evidence) is responsible for COM, as it is known to be a normal skin flora. […] Chronic osteomyelitis remains a very difficult orthopaedic challenge in SSA as well as other LICs, contrary to the western world where earlier diagnosis at an acute or subacute stage coupled with meticulous surgical technique minimize COM rate. […] The difference in incidence from Low- and High-Income countries does not only lie on surgical yield but also on difference in patients characteristics and associated co-morbidities. […] COM in SSA continues to be prevalent. […] The present study highlights common risk factors, incidences, and management options in SSA. […] Very limited data of high quality on COM in SSA currently exist, reporting its epidemiology and socio-economic burden it poses.
  • #30 Diagnosis and Management of Osteomyelitis | AAFP
    https://www.aafp.org/pubs/afp/issues/2001/0615/p2413.html
    Although the classification systems for osteomyelitis help describe the infection and determine the need for surgery, the categories do not apply to special circumstances (i.e., infections involving prosthetic joints, implanted materials or smaller bones of the body) or special types of infection (e.g., vertebral osteomyelitis). […] The incidence of deep musculoskeletal infection from open fractures has been reported to be as high as 23 percent. Patient factors, such as altered neutrophil defense, humoral immunity and cell-mediated immunity, can increase the risk of osteomyelitis. […] The specific microorganism(s) isolated from patients with bacterial osteomyelitis is often associated with the age of the patient or the clinical scenario. Staphylococcus aureus is implicated in most cases of acute hematogenous osteomyelitis and is responsible for up to 90 percent of cases in otherwise healthy children.
  • #31 New Antibiotics in the Therapy of Osteomyelitis – Mediterranean Journal of Infection Microbes and Antimicrobials
    https://mjima.org/articles/doi/mjima.2017.15
    Osteomyelitis is probably the oldest known infection in the history of life. […] Staphylococcus aureus is the most common bacterium isolated from bone samples in pediatric osteomyelitis, and the incidence of Kingella kingae in little children is rising, probably due to better detection and diagnostic performances. […] In adults, roughly half of osteomyelitis cases might be implant-associated. […] Therefore, the antimicrobial spectrum differs from pediatric osteomyelitis, in adults being 33% related to S. aureus and 32% to coagulase-negative staphylococci. […] Interestingly, pathogens isolated in recurrence of osteomyelitis in the same bone are different from the initial microbiology in 86% of cases. […] While hematogenous spread mostly leads to mono-bacterial infection, ulcer-related infection is usually polymicrobial.
  • #32 Epidemiology and Antibacterial Treatment of Acute…
    https://sciendo.com/article/10.1515/chilat-2017-0021
    Acute hematogenous osteomyelitis (AHO) is one of the most serious bacterial infections in children that may result in severe complications, such as sepsis, septic shock, bone and joint destruction, disruption of longitudinal bone growth, and even death. […] Early recognition and evaluation of severity of AHO, awareness of the local prevalence of different microorganisms, as well as timely initiated adequate treatment are crucial for prevention of serious complications. […] The main causative agent for AHO in the study patients was methicillin-sensitive Staphylococcus aureus (MSSA), which was isolated from blood cultures of 40% (n=24) of patients and from 79% (n=57) of intraoperative cultures. […] The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was low (found only in one patient, or 1.4%).
  • #33 Epidemiology, clinical manifestations, and diagnosis of osteomyelitis due to nontuberculous mycobacteria – UpToDate
    https://www.uptodate.com/contents/epidemiology-clinical-manifestations-and-diagnosis-of-osteomyelitis-due-to-nontuberculous-mycobacteria/print
    Epidemiology, clinical manifestations, and diagnosis of osteomyelitis due to nontuberculous mycobacteria […] The epidemiology, pathogenesis, clinical manifestations, and diagnosis of osteomyelitis due to NTM will be reviewed here. The treatment of osteomyelitis due to NTM is discussed separately. […] Osteomyelitis is a rare manifestation of nontuberculous mycobacteria (NTM) infection, which may occur in immunocompetent and immunocompromised hosts. A wide range of NTM species can cause osteomyelitis, including both rapidly and slowly growing mycobacteria. Osteomyelitis caused by NTM can result from environmental exposure or nosocomial exposure and has involved either penetrating injuries or postsurgical infections, such as sternal wound infections; such cases typically occur in immunocompetent hosts.
  • #34
    https://link.springer.com/article/10.1007/s12281-014-0200-3
    Fungal osteomyelitis is a severe and debilitating disease, affecting both immunocompetent and immunocompromised patients. Recent comprehensive reviews showed that the burden of fungal osteoarticular infections is steadily increasing due to the growing number of patients at risk. […] A comprehensive review of reported cases of Aspergillus osteomyelitis using high stringency, detailed case criteria to provide a resource for the diagnosis and treatment of this dreadful infection. […] An extensive review of the literature and meticulous analysis providing a new insight into dimorphic fungal osteoarticular infections. […] The most comprehensive review on osteoarticular infections caused by non-Aspergillus filamentous fungi, describing risk factors, routes of infection, treatment options, and outcomes.
  • #35 Aspergillus osteomyelitis: epidemiology, clinical manifestations, management, and outcome – Research – Institut Pasteur
    https://research.pasteur.fr/en/publication/aspergillus-osteomyelitis-epidemiology-clinical-manifestations-management-and-outcome/
    The epidemiology, pathogenesis, diagnosis, and management of Aspergillus osteomyelitis are not well understood. […] Among 180 evaluable patients, 127 (71%) were males. Possible predisposing medical conditions in 103 (57%) included pharmacological immunosuppression, primary immunodeficiency, and neutropenia. […] Aspergillus osteomyelitis was the first manifestation of aspergillosis in 77%. […] Overall mortality was 25%. […] Aspergillus osteomyelitis is a debilitating infection affecting both immunocompromised and immunocompetent patients.
  • #36 Expanding the definition beyond surveillance criteria reveals a large burden of osteomyelitis caused by group B Streptococcus in the United States Veterans Health Administration | BMC Infectious Diseases | Full Text
    https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07238-0
    Population-based surveillance studies may underestimate osteomyelitis caused by Group B Streptococcus (GBS). […] We analyzed cases of GBS osteomyelitis, including patients diagnosed using an expanded case definition that incorporates cultures from non-sterile sites, as well as cultures from normally sterile sites. […] The requirement of isolating GBS only from cultures of normally sterile sites may underestimate the burden of osteomyelitis caused by this pathogen. […] To better understand the epidemiology of GBS osteomyelitis, including cases diagnosed using cultures from non-sterile sites, we conducted a retrospective study using a cohort of patients who received care in hospitals from the US Veterans Health Administration (VHA) between 2008 and 2017. […] By incorporating cases identified through our expanded criteria for osteomyelitis that included GBS recovered from non-sterile sites, we demonstrated that the burden of disease caused by GBS osteomyelitis appears to be greater than previously recognized.
  • #37 Osteomyelitis – Market Insight, Epidemiology and Market Forecast -2032
    https://www.researchandmarkets.com/reports/5523966/osteomyelitis-market-insight-epidemiology-and?srsltid=AfmBOoqJRu65icLTxa6VJSdG3h5B4EUHWnUvcqpCUbPTkUd_j9JAYYOd
    The Osteomyelitis epidemiology division provide insights about historical and current Osteomyelitis patient pool and forecasted trend for every seven major countries. It helps to recognize the causes of current and forecasted trends by exploring numerous studies and views of key opinion leaders. This part of The report also provides the diagnosed patient pool and their trends along with assumptions undertaken. […] The disease epidemiology covered in the report provides historical as well as forecasted Osteomyelitis epidemiology scenario in the 7MM covering the United States, EU5 countries (Germany, Spain, Italy, France, and the United Kingdom), and Japan from 2019 to 2032. […] The epidemiology segment also provides the Osteomyelitis epidemiology data and findings across the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan.
  • #38 Expanding the definition beyond surveillance criteria reveals a large burden of osteomyelitis caused by group B Streptococcus in the United States Veterans Health Administration | BMC Infectious Diseases | Full Text
    https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07238-0
    Consequently, population-based surveillance of invasive GBS disease likely underestimates the overall incidence of GBS osteomyelitis. […] Accurate estimation of the burden of GBS osteomyelitis may help guide preventive efforts among patients at risk, mitigating the overall impact of this type of GBS infection.
  • #39 Medwin Publishers | Microbiological Epidemiology at Chris Hani BaragwanathAcademic Hospital: Poly-Microbial Osteomyelitis Analysis
    https://medwinpublishers.com/article-description.php?artId=11078
    The majority of the patients seen and treated at our clinical setting present during chronic osteomyelitis stage, which is anecdotally likely to be poly-microbial. […] Our study looks into the epidemiology of poly-microbial osteomyelitis treated at our Tumour and Infection unit. […] A slightly higher incidence of poly-microbial osteomyelitis was found in our study than that reported in literature. […] Furthermore, our study demonstrated a wide variety of organisms found in poly-microbial osteomyelitis, with a large contribution made by gram-negative anaerobic rod-shaped bacteria. […] What we suggest is tailoring antibiotics to the specific cultured bacteria and sensitivity.
  • #40 Trends in the Epidemiology of Osteomyelitis
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4642868/
    During follow-up of the entire osteomyelitis cohort, we observed 386 deaths when 141.2 deaths were expected on the basis of age, sex, and calendar year-specific death rates in the Minnesota population. This difference corresponded to a standardized mortality ratio of 2.73 (95% CI, 2.46 to 3.00), indicating that the risk of death is increased at least 2.5-fold. […] In this population-based study, we describe trends in the incidence of osteomyelitis over time and demonstrate that the epidemiology of osteomyelitis changed substantially over the four decades between 1969 and 2009.
  • #41 Osteomyelitis – Infectious Disease Advisor
    https://www.infectiousdiseaseadvisor.com/ddi/osteomyelitis/
    Osteomyelitis can be successfully treated with surgery and antibiotics. Disease prognosis improves with early detection and aggressive treatment. Surgical debridement improves outcomes better than conservative treatment. Chronic osteomyelitis recurs in roughly 30% of adults within 12 months; however, infection with Pseudomonas aeruginosa has a recurrence rate as high as 50%. […] Osteomyelitis treatment primarily consists of antibiotic therapy and surgical debridement of the infection site. Antibiotic selection is based on microbial cultures of blood and bone tissue. If possible, antibiotic therapy should be delayed until cultures have been obtained, as antibiotic therapy can result in false-negative blood cultures. […] Many complications can arise from untreated or inadequately treated osteomyelitis. Complications of osteomyelitis include abscess (in bone or soft tissue), bone deformity, contiguous soft tissue infection, osteonecrosis, pathologic fractures, septic arthritis, sinus tract formation, squamous cell carcinoma (at sinus tract site), and systemic infection. Osteomyelitis in pediatric patients affecting the endplates of the long bones can cause stunted growth. Early treatment is necessary to prevent serious complications.
  • #42 Current data on extremities chronic osteomyelitis in southwest China: epidemiology, microbiology and therapeutic conseq…
    https://ouci.dntb.gov.ua/en/works/96Z3bpN9/
    The incidence of hematogenous osteomyelitis is on the rise, and the prognosis is poor. […] The aim of this study was to investigate the epidemiological status, microbiological characteristics, treatment and financial burden of hematogenous osteomyelitis in Northwest China to explore the therapeutic effects of different treatment methods, elucidate the epidemiological characteristics of hematogenous osteomyelitis and to provide a basis for the choice of treatment. […] The financial burden of blood-borne osteomyelitis was lower than that of traumatic osteomyelitis.
  • #43 New Antibiotics in the Therapy of Osteomyelitis – Mediterranean Journal of Infection Microbes and Antimicrobials
    https://mjima.org/articles/doi/mjima.2017.15
    The detection of microbial agents remains crucial for the associated antibiotic therapy. […] Effectiveness of antibiotic therapy depends not only on its availability and concentration at the infection site, but also on susceptibility of the infectious agent. […] Overuse, misuse and easy availability of antibiotics in combination with the property of bacteria to evolve when subjected to selective pressure has lead to resistance. […] The latter is increasing worldwide and also affects Europe and certainly the countries around the Mediterranean sea. […] Unfortunately, only few new substances have been approved for osteomyelitis treatment in the last years, but several are currently being investigated.
  • #44 The global state of research and trends in osteomyelitis from 2010 to 2019: a 10-year bibliometric analysis – Chen – Annals of Palliative Medicine
    https://apm.amegroups.org/article/view/63390/html
    Osteomyelitis is a difficult problem for orthopedic surgeons due to its great harm and complicated treatment. […] Epidemiology, diabetic foot, treatment, especially antibiotics, biofilm and in vitro research were research frontiers. […] The research on the diagnosis, treatment and management strategy of osteomyelitis have attracted extensive attention from researchers. […] The research on the pathogenesis and treatment methods of osteomyelitis will be the trend and hotspots in the future. […] There is no doubt that the research on the diagnosis, treatment and management strategy of osteomyelitis have always received extensive attention from researchers. […] The focus of the researchers was different at different stages of the study. […] In the later stage (from 2014 to 2019), the epidemiology and treatment of osteomyelitis (such as surgery, antibiotics, biofilm, outcome) have become much more important research hotspots. […] The care of patients with osteomyelitis is multidisciplinary, requiring the communication and collaboration among orthopedics, radiology, microbiology, infectious diseases, nursing and community teams to obtain early diagnosis and effective treatment.
  • #45 Osteomyelitis
    https://www.abdn.ac.uk/medical/elf/courses/view/147853/osteomyelitis/1/page05
    Its complicated and contextual! […] Dependent on health of the general population, Infection Prevention and Control rigour and adequate preventative care for at-risk patients. […] The epidemiology of osteomyelitis varies greatly. […] It is important to know what environment you are working in and the pathogens that may be present, for example in Iraq and Afghanistan during the ISAF operations a lot of the mortality from blast injuries came from Invasive Fungal Infections, admittedly of both soft tissue and bone, (and its not exactly what your standard FY1 is going to see) but it is important to understand the environment you are in and assess the risk of infection. […] Most health boards across the UK have their own antimicrobial formulary and if you end up working 'down south’ or in a different health board to Grampian or Highland its worthwhile having a quick read of this before you start working so you are aware of what microbes are out there and what should be 'on your radar’.
  • #46 Acute and chronic osteomyelitis (Chapter 70) – Clinical Infectious Disease
    https://www.cambridge.org/core/books/clinical-infectious-disease/acute-and-chronic-osteomyelitis/75F31F569F4FBFA9FE1278F35C8D53F6
    Osteomyelitis is a common term for bone infection, although noninfectious inflammation of bones and adherent structures exist. […] Epidemiology of osteomyelitis is heterogeneous with variability among involved bones, pathogens, and settings. For example, resource-poor countries may reveal a higher proportion of tuberculous osteomyelitis or CO due to post-traumatic origin compared to resource-rich countries, as well as a higher prevalence of foot osteomyelitis among elderly patients.
  • #47 Epidemiology and Antibacterial Treatment of Acute…
    https://sciendo.com/article/10.1515/chilat-2017-0021
    The prevalence of MRSA at CCUH was very low, which must be considered when prescribing empirical antibacterial treatment, giving preference to narrow spectrum antibiotics. […] Establishment of local guidelines for management of AHO in children at CCUH, including necessary investigations, treatment algorithm for inpatient and outpatient use with defined duration of treatment and time of conversion to oral antibiotics, follow-up and clinical endpoint criteria, and information for parents or carers.
  • #48 The Epidemiology of Osteomyelitis in Children
    https://www.mdpi.com/2227-9067/8/11/1000
    In conclusion, pediatric osteomyelitis is a serious issue, even in a developed and industrialized country such as Germany. Considering the recent incidence increase, the permanent need for appropriate treatment should let pediatricians and orthopedic surgeons deal with diagnosis and treatment protocols.
  • #49 Osteomyelitis Market Size, Trends and Forecast 2025-2035
    https://www.imarcgroup.com/osteomyelitis-market
    What is the number of incident cases (2019-2035) of osteomyelitis across the seven major markets? […] What is the size of the osteomyelitis patient pool (2019-2024) across the seven major markets? […] What would be the forecasted patient pool (2025-2035) across the seven major markets? […] What are the key factors driving the epidemiological trend of osteomyelitis? […] What will be the growth rate of patients across the seven major markets?
  • #50 Pubic osteomyelitis: Epidemiology and factors associated with treatment failure – Archive ouverte HAL
    https://hal.science/hal-03493617/
    Objective: To describe the epidemiology of pubic osteomyelitis (PO) and to look for factors associated with treatment failure. […] Results: Twenty-five patients were included over a 13-year period; 24% of PO had blood-borne infection. […] Conclusion: PO is most often a chronic postoperative polymicrobial infection in patients with comorbidities at high risk of relapse. Studies in larger cohorts could assess the efficacy of more aggressive surgical strategies in patients at high risk of failure.

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