Health Sciences Post Graduation Program, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil.
Braz J Infect Dis. 2010 May-Jun;14(3):310-5.
Over the last 30 years, the pathogenesis of osteomyelitis has almost been totally elucidated, and many factors responsible for the persistence of this infection have been identified. Numerous antimicrobial agents with distinct spectrums of action, pharmacokinetics, and pharmacodynamics have been used in its treatment. Surgical techniques, including muscle grafts, the Ilizarov technique, and antibiotic bone cements, have been applied. However, bone infections are still a challenge. Despite the importance of isolation and identification of microorganisms to determine the antimicrobial treatment of bone infections, there are few systematic national studies about the etiological profile of these diseases. This article describes the current knowledge of osteomyelitis and summarizes published national data based on the experience of different Orthopedic and Traumatology Services. In general, S. aureus was described as an important etiological agent; however, the difference in design of national studies makes a comparison between the prevalence of bone infection, the associated risk factors, and the different therapeutic approaches difficult. In conclusion, effort is necessary in order to stimulate systematic national studies in different Orthopedics and Traumatology Services to obtain a better consensus on preventive measures and therapies of bone infections.
在过去的 30 年中，骨髓炎的发病机制几乎已经完全阐明，并且已经确定了许多导致这种感染持续存在的因素。在治疗中使用了许多具有不同作用谱、药代动力学和药效学的抗菌药物。外科技术，包括肌肉移植、伊利扎罗夫技术和抗生素骨水泥，也已应用于临床。然而，骨髓炎仍然是一个挑战。尽管微生物的分离和鉴定对于确定骨髓炎的抗菌治疗非常重要，但关于这些疾病的病因谱的系统的全国性研究很少。本文描述了骨髓炎的最新知识，并根据不同骨科和创伤科服务的经验总结了已发表的全国数据。一般来说，金黄色葡萄球菌被描述为重要的病因；然而，由于全国性研究设计的差异，使得比较骨髓炎的流行率、相关危险因素以及不同的治疗方法变得困难。总之，有必要努力在不同的骨科和创伤科服务中开展系统的全国性研究，以就骨髓炎的预防措施和治疗方法达成更好的共识。
