II. Causes: Acute Hematogenous Osteomyelitis - Age related Osteomyelitis organisms

  1. All Ages
    1. Staphylococcus aureus is the most common cause of hematogenous Osteomyelitis in Adults and children
  2. Age under 4 months
    1. Group B Streptococcus
    2. Staphylococcus aureus
    3. Escherichia coli
  3. Age 4 months to 4 years old
    1. Staphylococcus aureus
    2. Streptococcus Pneumoniae
    3. Streptococcus Pyogenes (Group A Streptococcus)
    4. HaemophilusInfluenzae was previously common prior to being part of primary Immunization series
    5. Kingella kingae
  4. Age 4 to 16 years
    1. Staphylococcus aureus
    2. Streptococcus Pneumoniae
    3. Streptococcus Pyogenes (Group A Streptococcus)
  5. Age over 16 years
    1. Staphylococcus aureus
      1. Most common
      2. MRSA accounts for one third of staphylococcal infections

III. Causes: Acute Contiguous Osteomyelitis

  1. Staphylococcus aureus
  2. Coagulase-negative staphylococci (esp. Staphylococcus epidermidis)
  3. Gram Negative Bacilli
  4. Streptococcus species
  5. Pseudomonas aeruginosa

IV. Causes: Chronic Osteomyelitis

  1. Staphylococcus aureus
  2. Pseudomonas aeruginosa
  3. Enterobacteriaceae (Serratia marcescens, Escherichia coli)
  4. Streptococcal species

V. Causes: Mechanism of Injury related Osteomyelitis organisms

  1. Foreign Body
    1. Propionibacterium
    2. Coagulase negative Staphylococcus
  2. Nosocomial Infection
    1. Pseudomonas aeruginosa
    2. Enterobacteriaceae
  3. Human or Animal Bites or fist injuries to mouth
    1. Streptococcus
    2. Anaerobic Bacteria
    3. Pasteurella multocida
    4. Eikenella corrodens
  4. Endemic infection exposure
    1. Brucella
    2. Coxiella Burnetii (Q Fever)

VI. Causes: Comorbid condition related Osteomyelitis organisms

  1. Diabetes Mellitus
    1. Streptococcus
    2. Anaerobic Bacteria
  2. Sickle Cell Anemia
    1. Streptococcus Pneumoniae
    2. Salmonella
  3. Human Immunodeficiency Virus (HIV)
    1. Bartonella Henselae
    2. Tuberculosis
  4. Immunocompromised conditions
    1. Aspergillus
    2. Mycobacterium avium-intracellulare
    3. Candida albicans
  5. IV Drug Abuse
    1. Polymicrobial infection in 46%
    2. Staphylococcus aureus (52%)
    3. Coagulase-negative Staphylococcus (20%)
    4. Gram-negative organisms (19%)
    5. Anaerobes (19%)
    6. Pseudomonas aeruginosa (7%)
    7. Allison (2010) Clin Orthop Relat Res 468(8): 2107–12 +PMID:20174899 [PubMed]

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