Abstract：Objective To analyze the etiology distribution and clinical characteristics of osteomyelitis patients，and to provide theoretical basis for etiology diagnosis and treatment of osteomyelitis patients.Methods We analyzed the clinical characteristics，pathogen distribution and drug resistance of 333 patients with osteomyelitis in our hospital from January 2018 to March 2020.300 cases of non bacterial infection were taken as negative control group.There were 333 cases in infection group，including 255 males and 78 females，with an average age of (40.19±17.91)years (range，2~98 years).There were 300 cases in the control group，189 males and 111 females，aged from 5 to 90 years，with an average of (34.80±23.67)years.The infection biomarkers of the two groups：procalcitonin (PCT)，C-reactive protein(CRP)，interleukin-6(IL-6) and neutrophil(neu) were compared by area under curve(AUC) of receiver operating characteristic curve(ROC).Results The main age distribution of infection group：244 Cases(73.27%) were 20~59 years old；48 cases (14.41%) were younger than 20 years old.The average number of hospitalizations was (2.22±1.80)times/person，and the average length of stay was (17.03±12.30)days.The first infection site was tibia(105 cases，31.5%)，followed by fumur(76 cases，22.8%)，jawbone (26 cases，7.8%) and calcaneus (25 cases，7.5%).The main sources of pathogenic bacteria were secretion，tissue fluid and blood culture，which were 42.51%(88/207)，15.46%(32/207) and 14.98%(31/207)，respectively.The operation rate of osteomyelitis patients was 71.17%(237/333)，including debridement and drainage in 126 cases(37.84%)，and fixed removal in 73 cases(21.93%)，etc.The positive rate of pathogenic bacteria was 62.16%(207/333)，Staphylococcus aureus was 64.25%(133/207).34 cases were mixed infection.The drug resistance rate of Staphylococcus aureus was 45.1% for oxacillin，91.0% for penicillin，and 0 for tegacyclin，vancomycin and linezolid.The area under ROC curve (AUC) of neu%，CRP，IL-6 and PCT were 0.534，0.670，0.356 and 0.257，respectively，which showed that only CRP had diagnostic value for osteomyelitis.When CRP≥0.937 mg/mL，the sensitivity was 0.639 and the specificity was 0.663.Conclusion The patients with osteomyelitis are characterized long treatment period，low detection rate of pathogenic bacteria and complicated，but Staphylococcus aureus is the most common pathogen.It is necessary to send the microbiological samples for identification，clinical antimicrobial susceptibility test and combined detection with CRP，so as to provide accurate diagnosis and guidance for clinical medication.
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