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Background  The purpose of this study was to gather temporal trends on bacteria epidemiology and resistance of intraoperative bone culture from chronic ostemyelitis at an affiliated hospital in South China.    Method  Records of patients with chronic osteomyelitis from 2003 to 2014 were retrospectively reviewed. The medical data were extracted using a unified protocol. Antimicrobial susceptibility testing was carried out by means of a unified protocol using the Kirby-Bauer method, results were analyzed according to Clinical and Laboratory Standards Institute definitions.    Result  Four hundred eighteen cases met our inclusion criteria. For pathogen distribution, the top five strains were  Staphylococcus aureus  (27.9%);  Pseudomonas aeruginosa  (12.1%);  Enterobacter cloacae  (9.5%);  Acinetobacter baumanii  (9.0%) and  Escherichia coli  (7.8%). Bacterial culture positive rate was decreased significantly among different year-groups. Mutiple bacterial infection rate was 28.1%. One strain of  Staphylococcus aureus  was resistant to linezolid and vancomycin. Resistance of  Pseudomonas aeruginosa  stains to Cefazolin, Cefuroxime, Cefotaxime, and Cefoxitin were 100% nearly. Resistance of  Acinetobacter baumanii  stains against Cefazolin, Cefuroxime were 100%. Ciprofloxacin resistance among  Escherichia coli  isolates increased from 25 to 44.4%. On the contrary, resistance of  Enterobacter cloacae  stains to Cefotaxime and Ceftazidime were decreased from 83.3 to 36.4%.    Conclusions  From 2003 to 2014, positive rate of intraoperative bone culture of chronic osteomyelitis was decreased; the proportion of  Staphylococcus aureus  was decreased gradually, and our results indicate the importance of bacterial surveilance studies about chronic osteomyelitis.

Bacterial resistance trends among intraoperative bone culture of chronic osteomyelitis in an affiliated hospital of South China for twelve years