Pubic osteomyelitis: Epidemiology and factors associated with treatment failure
Objective
To describe the epidemiology of pubic osteomyelitis (PO) and to look for factors associatedwith treatment failure.Method
Retrospective study describing PO according to outcome: success or failure of initial man-agement. Factors associated with failure determined by univariate Cox analysis. Kaplan-Meier curvecompared between groups by log-rank test.Results. – Twenty-five patients were included over a 13-year period; 24% of PO had blood-borne infection.Failure (44%) was always observed in chronic postoperative presentations (76%). Fistula (32%) was onlyobserved in postoperative presentations and was significantly associated with failure (HR 5.1; P = 0.011).Other risk factors were pelvic malignant tumor history, abscess, infection due to extended-spectrumbeta-lactamase-producing Enterobacteriaceae, and polymicrobial infection.Conclusion
PO is most often a chronic postoperative polymicrobial infection in patients with comorbidi-ties at high risk of relapse. Studies in larger cohorts could assess the efficacy of more aggressive surgicalstrategies in patients at high risk of failure.