Mackowiak P A, Jones S R, Smith J W
JAMA. 1978 Jun 30;239(26):2772-5. doi: 10.1001/jama.239.26.2772.
Sinus-tract cultures were compared with cultures of operative specimens from 40 patients with chronic osteomyelitis. Thirty-five patients (87.5%) had a single pathogen isolated from their operative specimens. Only 44% of the sinus-tract cultures contained the operative pathogen. Isolation of Staphyloccus aureus from sinus tracts correlated with the presence of S aureus in the operative specimen. However, less than half of the sinus-tract cultures obtained from patients with S aureus osteomyelitis contained this organism. Isolation of bacteria other than S aureus from sinus tracts had a low likelihood of predicting the pathogen isolated from bone. A presumptive diagnosis of S aureus osteomyelitis is justified if S aureus is isolated from an associated sinus tract. A bacteriologic diagnosis of chronic osteomyelitis based on isolation of common pathogens other than S aureus from sinus tracts must be verified by an appropriate operative culture.
对40例慢性骨髓炎患者的窦道培养物与手术标本培养物进行了比较。35例患者（87.5%）的手术标本中分离出单一病原体。窦道培养物中只有44%含有手术病原体。从窦道中分离出金黄色葡萄球菌与手术标本中存在金黄色葡萄球菌相关。然而，从金黄色葡萄球菌骨髓炎患者获得的窦道培养物中，不到一半含有该菌。从窦道中分离出除金黄色葡萄球菌以外的细菌，预测从骨中分离出的病原体的可能性较低。如果从相关窦道中分离出金黄色葡萄球菌，则金黄色葡萄球菌骨髓炎的推定诊断是合理的。基于从窦道中分离出除金黄色葡萄球菌以外的常见病原体对慢性骨髓炎进行细菌学诊断，必须通过适当的手术培养加以验证。
