Osteomyelitis Essay -- Health, Diseases

Osteomyelitis: Osteomyelitis is a common bone infection caused by bacteria or in some cases, fungus [1]. Osteomyelitis generally occurs by infection of bacteria in several different ways, including via the bloodstream, from neighboring areas of infection, or due to non-sterile joint replacements and internal fixations such as fractures [2]. In 90% of cases, an S. aereus bacterium is the microbial culprit responsible for osteomyelitis [3]. In the cases of open would fractures, osteomyelitis can interfere with normal bone healing and regeneration [4]. Symptoms of osteomyelitis include bone pain, fever, malaise, swelling, redness, chills, excessive sweating, and joint pains [5]. It is reported that in 20% of the cases, the infection is hematogenous, or spread by the blood [6]. The incidence of spinal osteomyelitis was reported to be 1 in 450,000 in 2001 [7]. The incidence of vertebral osteomyelitis is reported to be 24 cases per 1,000,000 and the incidence in children is approximately 1 in 5,00 0 [8]. Approximately 10-15% of people with vertebral osteomyelitis develop spinal-cord compression and approximately 30% of patients with long bone osteomyelitis develop deep vein thrombosis (DVT) [9]. Mortality rates are generally low unless sepsis occurs [10]. The overall incidence of osteomyelitis was found to be higher in developing countries compared to developed nations [11]. Current Clinical Standard of Care: The current gold standard treatment for osteomyelitis is gentamycin or vancomycin impregnated poly methyl methacrylate (PMMA) beads [12]. These beads are surgically implanted at the site of bacterial infection, and the antibiotic will diffuse from these beads [12]. Both vancomycin and gentamycin inhibit bacterial g... ..., the in vivo studies show that the effectiveness of the delivery system in terms of bacterial growth inhibition is comparable to the clinical standard of care, the PMMA beads. Further studies would include determining the compressive strengths of the PUR scaffolds to decide where they could be placed in a load-bearing setting, systemic toxicity studies to ensure that neither the vancomycin nor PUR is present in toxically high concentrations in the serum after implantation, and a prolonged study to show that the PUR scaffold is in fact biodegradable, thereby by-passing the second surgical step which is required for the PMMA beads. Li et al [21] also did not do any studies comparing the PUR-LTI and PUR-HDIt scaffolds under the same experimental conditions. These studies would also be critical to determine which scaffold formulation should be pursued long-term.