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Qu YD, Jiang N, Li JX, Zhang W, Xia CL, Ou SJ, Yang Y, Ma YF, Qi Y, Xu CP. Chronic osteomyelitis risk is associated with NLRP3 gene rs10754558 polymorphism in a Chinese Han Population. BMC Med Genomics 2024; 17:38. [PMID: 38287380 PMCID: PMC10823619 DOI: 10.1186/s12920-024-01799-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/08/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Single nucleotide polymorphisms (SNPs) in the nucleotide-binding domain leucine-rich repeat protein-3 (NLRP3) gene are reported to be linked to many inflammatory disorders. However, uncertainty persists over the associations between these SNPs and susceptibilities to chronic osteomyelitis (COM). This study aimed to investigate potential relationships between NLRP3 gene SNPs and the risks of developing COM in a Chinese Han cohort. METHODS The four tag SNPs of the NLRP3 gene were genotyped in a total of 428 COM patients and 368 healthy controlsusing the SNapShot technique. The genotype distribution, mutant allele frequency, and the four genetic models (dominant, recessive, homozygous, and heterozygous) of the four SNPs were compared between the two groups. RESULTS A significant association was found between rs10754558 polymorphism and the probability of COM occurence by the heterozygous model (P = 0.037, odds ratio [OR] = 1.541, 95% confidence interval [CI] = 1.025-2.319), indicating that rs10754558 may be associated with a higher risk of developing COM.In addition, possible relationship was found between rs7525979 polymorphism and the risk of COM development by the outcomes of homozygous (P = 0.073, OR = 0.453, 95% CI = 0.187-1.097) and recessive (P = 0.093, OR = 0.478, 95% CI = 0.198-1.151) models, though no statistical differences were obtained. CONCLUSIONS Outcomes of the present study showed, for the first time, that rs10754558 polymorphism of the NLRP3 gene may increase the risk of COM development in this Chinese Han population, with genotype CG as a risk factor. Nonetheless, this conclusion requires verification from further studies with a larger sample size.
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Grants
- 81972083, 82172197 National Natural Science Foundation of China
- 81972083, 82172197 National Natural Science Foundation of China
- 2020A0505100039 Guangdong Provincial Science and Technology Project
- 2022A1515012385 Guangdong Basic and Applied Basic Research Foundation
- 202201020303, 202102080052, 202102010057, 201804010226 Science and Technology Planning Project of Guangzhou
- 202201020303, 202102080052, 202102010057, 201804010226 Science and Technology Planning Project of Guangzhou
- 3D-A2020004, 3D-A2020002, YQ2019-009, C2020019 Science Foundation of Guangdong Second Provincial General Hospital
- 3D-A2020004, 3D-A2020002, YQ2019-009, C2020019 Science Foundation of Guangdong Second Provincial General Hospital
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Affiliation(s)
- Yu-Dun Qu
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China
| | - Nan Jiang
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, China
| | - Jia-Xuan Li
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China
| | - Wei Zhang
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China
| | - Chang-Liang Xia
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China
| | - Shuan-Ji Ou
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China
| | - Yang Yang
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China
| | - Yun-Fei Ma
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, China
| | - Yong Qi
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China.
| | - Chang-Peng Xu
- Department of Orthopaedics, Guangdong Second Provincial General Hospital, 466 Xingang Road, Haizhu District, 510317, Guangzhou, China.
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Jiang N. Personalized Medicine for Orthopaedic Disorders. J Pers Med 2023; 13:1553. [PMID: 38003868 PMCID: PMC10671926 DOI: 10.3390/jpm13111553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 10/22/2023] [Indexed: 11/26/2023] Open
Abstract
Orthopaedic disorders, also known as musculoskeletal disorders (MSDs), refer to diseases or injuries of the bone, joint, cartilage, muscle, tendon, nerve, and spinal disc [...].
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Affiliation(s)
- Nan Jiang
- Division of Orthopaedics & Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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3
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Jiang N, Wang BW, Chai YM, Wu XB, Tang PF, Zhang YZ, Yu B. Chinese expert consensus on diagnosis and treatment of infection after fracture fixation. Injury 2019; 50:1952-1958. [PMID: 31445830 DOI: 10.1016/j.injury.2019.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Currently, accurate diagnosis and successful treatment of infection after fracture fixation (IAFF) still impose great challenges. According to the onset of infection symptoms after implantation, IAFF is classified as early infection (<2 weeks), delayed infection (2∼10 weeks) and late infection (>10 weeks). Confirmation of IAFF should be supported by histopathological tests of intraoperative specimens which confirm infection, cultures from at least two suspected infection sites which reveal the same pathogen, a definite sinus or fistula which connects directly the bone or the implant, and purulent drainage from the wound or presence of pus during surgery. Diagnosis of IAFF is built on comprehensive assessment of medical history, clinical signs and symptoms of the patient, and imaging and laboratory tests. The gold standard of diagnosis is histopathological tests. Treatment of IAFF consists of radical debridement, adequate irrigation, implant handling, systematic and local antibiotics, reconstruction of osseous and/or soft tissue defects, and functional rehabilitation of an affected limb. Early accurate diagnosis and appropriate treatment of IAFF play a key role in increasing the cure rate, reducing infection recurrence and disability risk, restoring limb function and improving quality of life of the patient.
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Affiliation(s)
- Nan Jiang
- Department of Orthopaedics & Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Bo-Wei Wang
- Department of Orthopaedics & Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Yi-Min Chai
- Department of Orthopaedics, The Sixth People's Hospital of Shanghai Jiao Tong University, Shanghai, PR China
| | - Xin-Bao Wu
- Department of Orthopaedics & Traumatology, Beijing Jishuitan Hospital, Beijing, PR China.
| | - Pei-Fu Tang
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing, PR China.
| | - Ying-Ze Zhang
- Department of Orthopaedics, The Third Hospital of Hebei Medical University, Shijiazhuang, PR China.
| | - Bin Yu
- Department of Orthopaedics & Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
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Jiang N, Wu HT, Lin QR, Hu YJ, Yu B. Health Care Costs of Post-traumatic Osteomyelitis in China: Current Situation and Influencing Factors. J Surg Res 2019; 247:356-363. [PMID: 31679801 DOI: 10.1016/j.jss.2019.10.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 08/04/2019] [Accepted: 10/01/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Currently, very limited information is available regarding the economic burdens of patients with extremity post-traumatic osteomyelitis (OM). This study aimed to investigate direct health care costs and utilization for inpatients with extremity post-traumatic OM and analyze its constituent ratios and influencing factors in Southern China. METHODS We searched in the electronic medical record system for inpatients who had received surgical interventions at our department between 2013 and 2016 for extremity post-traumatic OM. Data of direct health care costs incurred during their hospitalizations were collected in six main categories (service, diagnosis, treatment, materials, pharmaceuticals, and miscellaneous expenses). In addition, data of total medical costs for contemporaneous inpatients with non-post-traumatic OM were also collected as controls. RESULTS A total of 278 post-traumatic OM and 10,420 controls were included. The median cost for the post-traumatic OM inpatients was $10,504 US dollars, 4.8-fold higher than that for those with non-post-traumatic OM ($2189, P < 0.001). The direct cost in the category of materials accounted for the largest proportion (61%), followed by that in pharmaceuticals (12%) and treatment (11%). The median number of hospital admissions for post-traumatic OM patients was 1 time, with a median length-of-stay of 22 d. The most influencing factors for the health care costs of the post-traumatic OM inpatients were use of an external fixator ($16,016 for those who used versus $4956 for those who did not, P < 0.001), external fixator type ($19,563 for ring fixator versus $14,966 for rail fixator, P < 0.001), infection site ($13,755 for tibia, $14,216 for femur and $5673 for calcaneus, P < 0.001), and infection-associated injury type ($12,890 for infection after open fracture versus $8087 for infection after closed fracture, P = 0.001). CONCLUSIONS An unexpectedly large proportion of the direct health care costs for inpatients with extremity post-traumatic OM went to cover an external fixator, with expenses for pharmaceuticals and treatment accounting for only a little more than the tenth of the total health care costs. Use of external fixator, external fixator type, infection site, and infection-associated injury type directly influenced the health care costs.
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Affiliation(s)
- Nan Jiang
- Department of Orthopaedics & Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Hang-Tian Wu
- Guangdong Provincial Key Laboratory of Bone & Cartilage Regenerative Medicine, Southern Medical University, Guangzhou, P.R. China
| | - Qing-Rong Lin
- Department of Orthopaedics & Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Yan-Jun Hu
- Department of Orthopaedics & Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China
| | - Bin Yu
- Department of Orthopaedics & Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, P.R. China; Guangdong Provincial Key Laboratory of Bone & Cartilage Regenerative Medicine, Southern Medical University, Guangzhou, P.R. China.
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Interleukin-1 Beta Gene Polymorphism rs16944 May Associate with Increased Susceptibility to Extremity Chronic Osteomyelitis in Chinese Han Population. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7483537. [PMID: 30949508 PMCID: PMC6425336 DOI: 10.1155/2019/7483537] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/16/2019] [Accepted: 01/31/2019] [Indexed: 01/10/2023]
Abstract
Background Previous studies had indicated that interleukin-1 beta (IL-1β) gene single nucleotide polymorphisms (SNPs) associate with different inflammatory diseases. However, potential links between these polymorphisms and susceptibility to extremity chronic osteomyelitis (COM) remain unclear. This study aimed to investigate relationships between IL-1β gene polymorphisms (rs16944, rs1143627, rs1143634, and rs2853550) and risks of developing extremity COM in Chinese Han population. Methods Altogether 233 extremity COM patients and 200 healthy controls were genotyped for the four tag SNPs of the IL-1β gene using the SNapShot genotyping method. Comparisons were performed regarding genotype distribution, mutant allele frequency, and four genetic models (dominant, recessive, homozygous, and heterozygous models) of the four SNPs between the two groups. Results Significant associations were identified between rs16944 polymorphism and the risk of developing COM by dominant model (P = 0.026, OR = 1.698, 95% CI 1.065-2.707) and heterozygous model (P = 0.030, OR = 1.733, 95% CI 1.055-2.847). Although no statistical differences were found of rs1143627 polymorphism between the two groups, there existed a trend that rs1143627 may be linked to an elevated risk of developing COM by outcomes of dominant (P = 0.061), homozygous (P = 0.080) and heterozygous (P = 0.095) models. However, no statistical correlations were found between rs1143634 and rs2853550 polymorphisms and susceptibility to COM in Chinese Han population. Conclusions To our knowledge, we reported for the first time that IL-1β gene rs16944 polymorphism may contribute to the increased susceptibility to extremity COM in Chinese Han population, with genotype of AG as a risk factor.
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Wang Y, Wang J, Deng Z, Jin J, Jiang H, Meng J, Xu H, Zhao J, Sun G, Qian H. Chronic Osteomyelitis Increases the Incidence of Type 2 Diabetes in Humans and Mice. Int J Biol Sci 2017; 13:1192-1202. [PMID: 29104510 PMCID: PMC5666334 DOI: 10.7150/ijbs.21379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/31/2017] [Indexed: 01/06/2023] Open
Abstract
Background: To compare the risk of type 2 diabetes (T2DM) between patients with and without chronic osteomyelitis (COM), both in humans and in mice, and to explore risk factors in COM patients who developed T2DM. Methods: One hundred seven patients with COM and 114 patients without COM were consecutively enrolled and retrospectively analysed. Clinical data concerning the time to develop diabetes, glucose metabolism, lipid metabolism, inflammatory factors, mental health and frequency of specialist visits were collected. A mouse model of osteomyelitis was used to verify the presence of impaired glucose metabolism and depression. All data were processed by SPSS. Results: The incidence of T2DM was 2.37-fold higher in patients with COM than in those without. In COM patients, subjects with T2DM (DDM) had higher BMI, less exercise and more frequent visits to specialists than those without (Con). Glucose and lipid metabolism were worse in patients with DDM. Patients with DDM had higher levels of white blood cells (12.9±2.1×109/L vs. 11.7±2.2×109/L, p=0.027), CRP (28.4±4.5 mg/L vs. 22.0±4.8 mg/L, p<0.001), TNF-α (13.5±5.0 pg/mL vs. 9.4±2.6 pg/mL, p= 0.003) and IL-6 (12.9±3.2 pg/mL vs. 9.2±2.7 pg/mL, p<0.001). Significantly increased fasting blood glucose concentrations and impairment of oral glucose tolerance tests were also observed in mice modelling osteomyelitis, which were accompanied by elevated TNF-α and IL-6 levels. Furthermore, the proportion of depression (63.2% vs. 35.2%, p=0.003) and severe anxiety (31.6% vs. 9.1%, p=0.002) were significantly higher in the DDM group. Osteomyelitis mice showed obvious depressive-like behaviours. The levels of TNF-α, IL-6, CRP, BMI, and LDL; lack of exercise; SAS; HAQ; and SF36 assessment were risk factors for the development of T2DM in COM patients. Conclusions: Chronic osteomyelitis increased the incidence of T2DM in both humans and mice. Inflammation, mental illness and lack of exercise were risk factors for the occurrence of T2DM in osteomyelitis. Comprehensive consideration of patient history, including metabolism and mental health, is needed in planning future treatment.
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Affiliation(s)
- Yicun Wang
- Department of Orthopedics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Jun Wang
- Department of Orthopedics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Zhantao Deng
- Department of Orthopedics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China.,Center for Translational Medicine, Nanjing University Medical School, Nanjing, Jiangsu, PR China.,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, PR China
| | - Jiewen Jin
- Center for Translational Medicine, Nanjing University Medical School, Nanjing, Jiangsu, PR China.,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, PR China
| | - Hui Jiang
- Department of Orthopedics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Jia Meng
- Department of Orthopedics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Haidong Xu
- Department of Orthopedics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Jianning Zhao
- Department of Orthopedics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Guojing Sun
- Department of Orthopedics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
| | - Hongbo Qian
- Department of Orthopedics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu, China
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7
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Jiang N, Qin CH, Hou YL, Yao ZL, Yu B. Serum TNF-α, erythrocyte sedimentation rate and IL-6 are more valuable biomarkers for assisted diagnosis of extremity chronic osteomyelitis. Biomark Med 2017; 11:597-605. [PMID: 28770614 DOI: 10.2217/bmm-2017-0082] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: This study aimed to investigate the values of preoperative serum levels of white blood cell, erythrocyte sedimentation rate (ESR), C-reactive protein, procalcitonin, IL-6, TNF-α and serum amyloid A for diagnosis of chronic osteomyelitis (COM) in Chinese patients. Methods: All 586 eligible patients were included for analysis. Results: Outcomes revealed that positive ratios of TNF-α, ESR and IL-6 lied in top three. Taken predicted probability and detection cost into consideration, combination of ESR, IL-6 and TNF-α might be the optimal model due to its high predicted probability for COM (91.02%) with an acceptable cost (CN¥161). Conclusion: Combination of preoperative serum TNF-α, ESR and IL-6 can help a reliable predication of COM.
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Affiliation(s)
- Nan Jiang
- Department of Orthopedics & Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, PR China
- Guangdong Provincial Key Laboratory of Bone & Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, PR China
| | - Cheng-he Qin
- Department of Orthopedics & Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, PR China
| | - Yi-long Hou
- Guangdong Provincial Key Laboratory of Bone & Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, PR China
| | - Zi-long Yao
- Guangdong Provincial Key Laboratory of Bone & Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, PR China
| | - Bin Yu
- Department of Orthopedics & Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, PR China
- Guangdong Provincial Key Laboratory of Bone & Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, PR China
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Wang L, Jiang N, Lin QR, Qin CH, Hu YJ, Yu B. Cyclooxygenase-2 (COX-2) polymorphism rs689466 may contribute to the increased susceptibility to post-traumatic osteomyelitis in Chinese population. Infect Dis (Lond) 2017; 49:817-823. [PMID: 28682162 DOI: 10.1080/23744235.2017.1347816] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Lei Wang
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Nan Jiang
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Qing-rong Lin
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Cheng-he Qin
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Yan-jun Hu
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Bin Yu
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
- Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
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Peng J, Ren Y, He W, Li Z, Yang J, Liu Y, Zheng Z, Kates SL, Schwarz EM, Xie C, Xu Y. Epidemiological, Clinical and Microbiological Characteristics of Patients with Post-Traumatic Osteomyelitis of Limb Fractures in Southwest China: A Hospital-Based Study. J Bone Jt Infect 2017; 2:149-153. [PMID: 28540152 PMCID: PMC5441147 DOI: 10.7150/jbji.20002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective To determine the epidemiological, clinical and microbiological characteristics, of patients with post-traumatic osteomyelitis of extremity fractures, and provide evidence-based guidelines for early diagnosis and treatment, including empiric antibiotic therapy. Methods Human subject research was performed using institutional review board approved protocols. A retrospective chart review was conducted on 5,368 patients diagnosed with extremity traumatic fractures from January 1, 2012 to December 31, 2015, to identify osteomyelitis patients. Records from the Microbiology Department were reviewed, and patients with a positive wound culture, or bone biopsy culture, were selected for the study. Microbial suceptability was determined by the M-100-S22 protocol (Clinical & Laboratory Standards Institute® (CLSI) 2012 USA). Additional clinical information, including data on patients' baseline epidemiological, clinical, and microbiological records was collected from all available charts, and reviewed using a designed protocol. Results 84 (1.56%) patients were diagnosed with osteomyelitis based on a positive culture result. The most prevalent comorbidities in these patients were compartment syndrome, diabetes and hypertension. The most commonly involved infected site was the tibia-fibula (47.62%). 66 (78.57%) of these cases were monomicrobial, and 18 cases (21.43%) were polymicrobial. The infections were predominantly caused by Gram-positive bacteria (56, 53.85%). The most common Gram-positive bacteria were Staphylococcus aureus (39 cases, 37.50%) and S. epidermidis (6 cases, 5.77%), which were sensitive to ampicillin, synercid/ dalfopristin, linezolid, tigecycline, macrodantin, and vancomycin. S. aureus was the most common pathogen in both monomicrobial and polymicrobial cases. All 17 cases of MRSA infection were sensitive to Imezolid, ampicillin, synercid/ dalfopristin, linezolid, tigecycline, furadantin, piperacillin/yaz, rifampicin, and vancomycin, respectively. The most common Gram-negative bacteria were E. coli (16 cases, 15.38%) and Enterobacter cloacae (11 cases, 10.58%), which were sensitive to thienamycin. Conclusions In this study, the overall rate of post-traumatic osteomyelitis of limb fractures (1.56%) is lower than the national average rate (2.6-7.8%), for major medical centers in China. The main medical comorbidities were compartment syndrome, diabetes mellitus and hypertension. The most common infection was monomicrobial in lower extremities. S. aureus was the most common pathogen, which presented in 39 (37.50%) cases, and 17 of these (43.59%) were caused by MRSA. These findings can guide empiric antibiotic therapy in Southwest China for osteomyelitis in patients with traumatic limb fractures.
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Affiliation(s)
- Jiachen Peng
- Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China.,Joint Orthopaedic Research Center of Zunyi Medical University & University of Rochester Medical Center, Zunyi 563000, China.,Department of Orthopedics, Affiliated Hospital of Zunyi Medical College, Zunyi 563000, China
| | - Youliang Ren
- Joint Orthopaedic Research Center of Zunyi Medical University & University of Rochester Medical Center, Zunyi 563000, China.,Department of Orthopedics, Affiliated Hospital of Zunyi Medical College, Zunyi 563000, China
| | - Wenbin He
- Joint Orthopaedic Research Center of Zunyi Medical University & University of Rochester Medical Center, Zunyi 563000, China.,Department of Orthopedics, Affiliated Hospital of Zunyi Medical College, Zunyi 563000, China
| | - Zhengdao Li
- Joint Orthopaedic Research Center of Zunyi Medical University & University of Rochester Medical Center, Zunyi 563000, China.,Department of Orthopedics, Affiliated Hospital of Zunyi Medical College, Zunyi 563000, China
| | - Jin Yang
- Joint Orthopaedic Research Center of Zunyi Medical University & University of Rochester Medical Center, Zunyi 563000, China.,Department of Orthopedics, Affiliated Hospital of Zunyi Medical College, Zunyi 563000, China
| | - Yi Liu
- Joint Orthopaedic Research Center of Zunyi Medical University & University of Rochester Medical Center, Zunyi 563000, China.,Department of Orthopedics, Affiliated Hospital of Zunyi Medical College, Zunyi 563000, China
| | - Zhonghui Zheng
- Department of Orthopedics, The Second Affiliated Hospital of Central South University, Changsha 410011, China.,Department of Orthopaedics, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester NY 14642 USA
| | - Stephen L Kates
- Joint Orthopaedic Research Center of Zunyi Medical University & University of Rochester Medical Center, Zunyi 563000, China.,Department of Orthopaedics, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester NY 14642 USA.,Department of Orthopedics, Virginia Commonwealth University, Richmond, VA 23298 USA
| | - Edward M Schwarz
- Joint Orthopaedic Research Center of Zunyi Medical University & University of Rochester Medical Center, Zunyi 563000, China.,Department of Orthopaedics, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester NY 14642 USA
| | - Chao Xie
- Joint Orthopaedic Research Center of Zunyi Medical University & University of Rochester Medical Center, Zunyi 563000, China.,Department of Orthopaedics, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester NY 14642 USA
| | - Youjia Xu
- Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China
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Increased subsequent risk of erectile dysfunction among middle and old age males with chronic osteomyelitis: a nationwide population-based cohort study. Int J Impot Res 2016; 28:143-7. [PMID: 27169492 DOI: 10.1038/ijir.2016.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/25/2015] [Accepted: 10/26/2015] [Indexed: 01/27/2023]
Abstract
Chronic inflammation may cause endothelial dysfunction and atherosclerosis, resulting in subsequent erectile dysfunction (ED). We examined the relationship between chronic osteomyelitis, which is a chronic inflammatory disease, and ED. A retrospective cohort study was conducted using data from the National Health Insurance Research Database. After excluding patients <40 years of age, 677 male patients newly diagnosed with chronic osteomyelitis (COM) from 1 January 2000 to 31 December 2011 were identified for the study. The non-osteomyelitis comparison cohort consisted of 2706 male participants. The incidence of ED was 2.66-fold higher in the COM cohort than in the non-osteomyelitis cohort (4.01 vs 1.51 per 10 000 person-years). After adjusting for age and comorbidities of coronary heart disease, hypertension, hyperlipidemia, depression, stroke, diabetes, peripheral vascular disease, chronic kidney disease, chronic obstructive pulmonary disease and asthma, the patients with COM had a 2.82-fold risk of ED (95% confidence interval=1.44-5.56). The incidence of ED increased with that of comorbidities in both cohorts. The highest hazard ratio was in patients between 40 and 59 years of age who had COM. Our data showed, for the first time, that COM is a possible risk factor for the development of ED.
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Huang CC, Tsai KT, Weng SF, Lin HJ, Huang HS, Wang JJ, Guo HR, Hsu CC. Chronic osteomyelitis increases long-term mortality risk in the elderly: a nationwide population-based cohort study. BMC Geriatr 2016; 16:72. [PMID: 27029408 PMCID: PMC4815108 DOI: 10.1186/s12877-016-0248-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 03/23/2016] [Indexed: 11/29/2022] Open
Abstract
Background The elderly are predisposed to chronic osteomyelitis because of the immunocompromised nature of aging and increasing number of chronic comorbidities. Chronic osteomyelitis may significantly affect the health of the elderly; however, its impact on long-term mortality remains unclear. We conceived this retrospective nationwide population-based cohort study to address this issue. Methods We identified 10,615 elderly patients (≥65 years) comprising 965 patients with chronic osteomyelitis and 9650 without chronic osteomyelitis matched at a ratio of 1:10 by age and gender between 1999 and 2010 from the Taiwan National Health Insurance Research Database. The risk of chronic osteomyelitis between the two cohorts was compared by a following-up until 2011. Results Patients with chronic osteomyelitis had a significantly higher mortality risk than those without chronic osteomyelitis [incidence rate ratio (IRR): 2.29; 95 % confidence interval (CI): 2.01–2.59], particularly the old elderly (≥85 years; IRR: 3.27; 95 % CI: 2.22–4.82) and males (IRR: 2.7; 95 % CI: 2.31–3.16). The highest mortality risk was observed in the first month (IRR: 5.01; 95 % CI: 2.02–12.42), and it remained persistently higher even after 6 years (IRR: 1.53; 95 % CI: 1.13–2.06) of follow-up. Cox proportional hazard regression analysis showed that chronic osteomyelitis [adjusted hazard ratio (AHR): 1.89; 95 % CI: 1.66–2.15], advanced age (≥85 years; AHR: 2.02; 95 % CI: 1.70–2.41), male (AHR: 1.34; 95 % CI: 1.22–1.48), and chronic comorbidities were independent predictors of mortality. Conclusions This study demonstrated that chronic osteomyelitis significantly increased the long-term mortality risk in the elderly. Therefore, strategies for prevention and treatment of chronic osteomyelitis and concomitant control of chronic comorbidities are very important for the management of the elderly, particularly for a future with an increasingly aged population worldwide.
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Affiliation(s)
- Chien-Cheng Huang
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan.,Bachelor Program of Senior Service, Southern Taiwan University of Science and Technology, Tainan, Taiwan.,Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan, Taiwan.,Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Kang-Ting Tsai
- Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan, Taiwan.,Graduate Institute of Medical Sciences, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Jung Lin
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan.,Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.,Department of Emergency Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hung-Sheng Huang
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan.,Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
| | - How-Ran Guo
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Chien-Chin Hsu
- Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan. .,Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
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Lai SW, Lai HC, Lin CL, Liao KF, Tseng CH. Chronic osteomyelitis correlates with increased risk of acute pancreatitis in a case-control study in Taiwan. Eur J Intern Med 2015; 26:429-32. [PMID: 26058987 DOI: 10.1016/j.ejim.2015.05.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 05/13/2015] [Accepted: 05/14/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The objective of this study was to examine the relationship between chronic osteomyelitis and acute pancreatitis in Taiwan. METHODS This was a population-based case-control study utilizing the database of the Taiwan National Health Insurance Program. We identified 7678 cases aged 20-84 with newly diagnosed acute pancreatitis during the period of 1998 to 2011. From the same database, 30,712 subjects without diagnosis of acute pancreatitis were selected as controls. The cases and controls were matched with sex, age and index year of diagnosing acute pancreatitis. The odds ratio with 95% confidence interval of acute pancreatitis associated with chronic osteomyelitis was examined by the multivariable unconditional logistic regression analysis. RESULTS After adjustment for multiple confounders, the multivariable analysis showed that the adjusted odds ratio of acute pancreatitis was 1.93 for subjects with chronic osteomyelitis (95% confidence interval 1.01, 3.69), when compared with subjects without chronic osteomyelitis. CONCLUSIONS Chronic osteomyelitis correlates with increased risk of acute pancreatitis. Patients with chronic osteomyelitis should be carefully monitored about the risk of acute pancreatitis.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hsueh-Chou Lai
- College of Chinese Medicine, China Medical University, Taichung, Taiwan; Division of Hepato-gastroenterology, Department of Internal Medicine, China Medical University Hospital, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- Graduate Institute of Integrated Medicine, China Medical University, Taichung Tzu Chi General Hospital, Taichung, Taiwan; Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan; College of Medicine, Tzu Chi University, Hualien, Taiwan.
| | - Chun-Hung Tseng
- College of Medicine, China Medical University, Taichung, Taiwan; Department of Neurology, China Medical University Hospital, Taichung, Taiwan
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Lin SY, Lin CL, Tseng CH, Chang YJ, Wang IK, Yeh HC, Kao CH. Association Between Chronic Osteomyelitis and Risk of End-Stage Renal Disease: A Nationwide Population-Based Cohort Study. Medicine (Baltimore) 2015; 94:e1141. [PMID: 26166123 PMCID: PMC4504595 DOI: 10.1097/md.0000000000001141] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Inflammation, which initiates endothelial dysfunction, vascular atherosclerosis, and oxidative stress, may negatively influence renal function and accelerate the development of end-stage renal disease (ESRD). The role of chronic osteomyelitis (COM), a chronic inflammatory disease, in the development of ESRD has not been investigated. This study explored whether patients with COM have a higher risk of ESRD than that of patients without COM.Taiwan National Health Insurance claims from 1997 to 2010 were used to identify 24,267 newly diagnosed patients with COM and 97,068 age- and sex-matched non-COM controls for comparison. The risks of ESRD among COM patients, with adjustment for comorbidities, namely, hypertension, diabetes, coronary artery disease, congestive heart failure, and hyperlipidemia, were assessed until the end of 2010.ESRD risk was 2.01-fold higher (95% confidence interval [CI]: 1.81-2.25) in the COM cohort than in the non-COM cohort. Regarding the joint effect of COM with comorbidity, the ESRD risk was 1.57-fold higher (95% CI: 1.23-2.00) for the COM cohort without comorbidities and increased to 2.25 (95% CI: 1.97-2.57) for the COM cohort with at least 1 comorbidity. Age-specific analysis revealed that the adjusted ESRD risk for the COM cohort increased as age decreased, with the highest hazard ratio being 17.8 (95% CI: 5.18-61.4) for patients aged 20-34 years.This was the first study to report that COM is associated with an increased risk of ESRD, particularly among patients with comorbidities and younger patients.
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Affiliation(s)
- Shih-Yi Lin
- From the Graduate Institute of Clinical Medical Science (SY-L, IK-W), College of Medicine, China Medical University; Division of Nephrology and Kidney Institute (SY-L, IK-W, HC-Y); Management Office for Health Data (CL-L), China Medical University Hospital; College of Medicine (CL-L), China Medical University; Department of Neurology (CH-T), China Medical University Hospital, Taichung; Department of Health Promotion and Health Education (YJ-C), National Taiwan Normal University, Taipei; Graduate Institute of Clinical Medical Science and School of Medicine (CH-K), College of Medicine, China Medical University; and Department of Nuclear Medicine and PET Center (CH-K), China Medical University Hospital, Taichung, Taiwan
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