Culture of Bone Sinus Track

Abstract

Background: Sinus track represents the site of
drainage of chronic osteomyelitis, and is caused by
improper treatment of acute hematogenous
osteomyelitis ended with sequestrum formation,
trauma results in compound fracture, post operative
complications of the bone operation, and / or
tuberculous osteomyelitis. Sinus track culture of
chronic osteomyelitis is a very important & difficult
subject to deal with, because collection and
cultivation of material need patience and skillful to
reach best results
Mthods: Culture comparison of sinus track and
operative specimens was performed on 20 patients
with chronic osteomyelitis. This was conducted to
isolate the causative microorganisms of the chronic
sinuses discharge.
The investigation included a prospective study
during the period from October 1999- August 2000
in Tikrit Teaching Hospital.
The aim of the study was to culture compare
between the reliability of sinus track with bone
specimen obtained by operative method to know
actual causative agent of chronic bone infection.
Results: Eighteen patients (90%) had a single
isolated pathogen from their operative and sinus
specimens, while 2 (10%) patients have more than
one organism.
Sinus track cultures show the specificity of 100%
and predictive value of 91.6%, while sensitivity
shows 94.5%, was more dependent in the study.
Sinus track cultures were proved to be unreliable
source for the isolation of Staph. epidermidis while
it is proved to be a reliable source for isolation of
other type of bacteria caused chronic osteomyelitis.
Isolation of Staph. aureus from sinus track correlated
with the presence of Staph. aureus in the operative
specimen.
Conclusion: Syringe aspiration of material is
proved to be more reliable than cotton swab.
A cotton swab can miss most of the causative
organisms especially the anaerobes and specific
bacteria as Mycobacterium tuberculosis, or it may
contain some contaminants. Mycobacterial isolation
was limited to only 2 patients in the present study.
Keywords:Chronic,osteomyelitis, sinus