Microbiology of Bone and Joint Infections

This chapter discusses microorganisms in osteomyelitis, microorganisms in implant-associated bone and joint infection, microorganisms in native joint arthritis, diagnostic approach in osteomyelitis, and diagnostic approach in native joint infection. Osteomyelitis can occur as a result of contiguous spread from surrounding soft tissues or joints. Alternatively, it may result from hematogenous seeding or direct inoculation of microorganisms into the bone. In hematogenous osteomyelitis, infection is typically monobacterial, whereas in contiguous (exogenous) infection, it is often polymicrobial. Although the diagnostic value of serum C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR) is limited due to their low specificity, they may be useful to follow the response to therapy. Septic arthritis is considered an emergency because of the potential for rapid joint destruction with irreversible loss of function.