Epidemiology
- It’s complicated – and contextual!
- Dependent on health of the general population, Infection Prevention and Control rigour and adequate preventative care for at-risk patients.
- A theatre in a refugee camp will have a much higher rate of OM than an elective theatre list at Woodend.
- Very dependent on environment – risk of fungal infections.
The epidemiology of osteomyelitis varies greatly
When working abroad, or in other health systems or charities it is an especially important consideration. Those interested in humanitarian or military medicine you will likely have heard horror stories of doctors performing complex operations and (unexpectedly) ending up with a widespread OM infection, the bone crumbling, implant failing, patient going into sepsis and dying.
This is a very real problem and for those who go on to work with MSF, the Red Cross or Malteser International it is important you know about the infection risk and you adjust your expectations accordingly.
It is important to know what environment you are working in and the pathogens that may be present, for example in Iraq and Afghanistan during the ISAF operations a lot of the mortality from blast injuries came from Invasive Fungal Infections, admittedly of both soft tissue and bone, (and its not exactly what your standard FY1 is going to see) but it is important to understand the environment you are in and assess the risk of infection. That will determine your management plan for a lot of patients in these environments.
Most health boards across the UK have their own antimicrobial formulary and if you end up working 'down south' or in a different health board to Grampian or Highland its worthwhile having a quick read of this before you start working so you are aware of what microbes are out there and what should be 'on your radar'. For example, the microbe profile of Greater London is going to be very different to the microbe profile of the Gilbert Bain hospital in Shetland.
