Culture of bone sinus track

Abstract EN

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.