Concordance of bone and non-bone specimens in microbiological diagnosis of osteomyelitis: A systematic review and meta-analysis



Tawfik GM, Dibas M, Dung NM, Alkhebairy AA, Mahmoud MH, Ibrahim MH, Abd Elhady NR, Sayed AM, Gehad AS, Abdelrahman AS, Elfaituri MK, Nam NH, El-Qushayri AE, Huy NT.


J Infect Public Health. 2020 Nov;13(11):1682-1693. doi: 10.1016/j.jiph.2020.08.010. Epub 2020 Sep 20.


BACKGROUND: The diagnosis of osteomyelitis is invasive and expensive as the current standard technique is the bone biopsy. Our aim was to compare the degree of agreement and concordance between standard bone biopsy and other non-bone techniques. METHODS: We performed an electronic search through 12 electronic databases to retrieve relevant studeis. Our criteria included any original article that reported the degree of agreement and/or the concordance between bone biopsy and other non-bone techniques in diagnosing osteomyelitis. We published our protocol in PROSPERO with a registration number, CRD42017080336. RESULTS: There were 29 studies included in the qualitative analysis, of which 15 studies were included in the meta-analysis. Samples from sinus tract had the highest concordance with bone biopsy samples, while swab samples were the least concordant with bone biopsy samples. Additionally, Staphylococcus aureus was the most common bacteria isolated and the most concordant from samples, compared to other types of causative agents. Sinus tract had a significantly very high degree of agreement with bone samples. S. aureus had the highest degree of agreement in bone smaples. CONCLUSION: Diagnosis of osteomyelitis using sinus tract swab is close in results’ accuracy to bone biopsy. S. aureus was the most common extracted organism found in these samples and had the highest degree of agreement. CI – Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

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Link/DOI: 10.1016/j.jiph.2020.08.010