{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:24:44Z","timestamp":1787117084723,"version":"build-2736575974"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate pathogen epidemiology and clinical characteristics in osteomyelitis patients for optimizing clinical management strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Confirmed osteomyelitis cases required pathogen isolation with radiological correlation. The cohort included both confirmed (culture\u2212positive) and probable (culture\u2212negative but meeting clinical and radiological criteria) cases, Radiation-induced osteomyelitis, sclerosing osteomyelitis and drug\u2212associated osteomyelitis. Clinical specimens underwent standardized culture and VITEK Compact II or MALDI-TOF MS identification. SPSS 22.0 analyzed data via Mann-Whitney U tests and logistic regression for prolonged outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Analysis of 704 osteomyelitis patients revealed a male predominance (2.5:1 ratio) with median age at presentation of 41.4 years (IQR 27.0\u201355.0). Mortality was low (0.7%), but disability\/amputation occurred in 3.53%. Patients experienced median cumulative hospitalization of 22 days (IQR 15.0-38.2) and disease duration of 4.7 months (IQR 1.5-13.6), with 79.7% undergoing surgical intervention (primarily lesion resection [22.7%] or debridement [14.2%]). The tibia was the most frequent infection site (31.5%), followed by femur (18.4%) and Jawbone (9.7%). Fracture-related infections predominated pathogenetically (47.7%), showing tibial (47.3%) and femoral (23.8%) predominance with\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (50.4%) as the leading pathogen. Microbiological confirmation was achieved in 61.9% (439\/704) of cases, yielding 546 isolates.\n                      <jats:italic>S.aureus<\/jats:italic>\n                      predominated (50.8%), with 35.4% being MRSA (all susceptible to vancomycin\/linezolid\/tigecycline). Fracture-related infection (OR 2.24, p&amp;lt;0.001), femur involvement (OR 3.09, p&amp;lt;0.001), tibia involvement (OR 2.53, p&amp;lt;0.001), pathogen-positive culture (OR 3.56, p&amp;lt;0.001), MRSA (OR 2.64, p&amp;lt;0.001), and polymicrobial infection (OR 2.62, p&amp;lt;0.001) as significant predictors of prolonged hospitalization (&amp;gt;30 days). For prolonged clinical disease course (&amp;gt;6weeks), significant predictors included fracture-related infection (OR 1.83, p&amp;lt;0.001), femur involvement (OR 1.93, p=0.003), pathogen-positive culture (OR 2.66, p&amp;lt;0.001),\n                      <jats:italic>S. aureus<\/jats:italic>\n                      isolation (OR 1.79, p=0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In conclusion, fracture, femur involvement,\n                      <jats:italic>S. aureus<\/jats:italic>\n                      , and positive pathogen culture predict prolonged osteomyelitis hospitalization and disease course, jaw and finger bone sites predict shorter hospitalization. Pathogen epidemiology and infection site dictate clinical management strategies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1654595","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:35:33Z","timestamp":1787114133000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for prolonged hospitalization and disease course in osteomyelitis: a single\u2212centre cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Qiangsheng","family":"Feng","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, The 940th Hospital of Joint Logistics Support Force of People\u2019s Liberation Army","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuejuan","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The 940th Hospital of Joint Logistics Support Force of People\u2019s Liberation Army","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqin","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The 940th Hospital of Joint Logistics Support Force of People\u2019s Liberation Army","place":["Lanzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"B4","doi-asserted-by":"publisher","first-page":"e26","DOI":"10.1093\/cid\/civ482","article-title":"2015 infectious diseases society of America (IDSA) clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults","volume":"61","author":"Berbari","year":"2015","journal-title":"Clin. 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