To analyze the results of bone microbiological and histopathological study in patients with suspected diabetic foot osteomyelitis in order to improve diagnostic level of diabetic foot osteomyelitis.

Bone tissue of twenty-six inpatients with diabetic foot according to positive probe-to-bone test or bone exposure in ulcers was debrided for microbiological and histopathological study, and the positive results of microbiological and histopathological study were analyzed which included the positive rates, the species of bacteria, the sensitivity to the common antibiotics and clinical outcomes of patients.

84.6% patients were definitely diagnosed with diabetic foot osteomyelitis according to bone microbiological and histopathological study. Twenty species of bacteria and one specie of fungi were isolated from a total of 38 cases of bone microbiological studies. More than one bone microbiological culture were carried out in 13 patients and more than one sorts of bacteria were isolated from bone microbiological cultures of 10 patients. Compared to control, the patients for more than one bone microbiological culture and infected by more than one sorts of bacteria had shorter duration of diabetic foot, higher level of white cell and neutrophil counts, erythrocyte sedimentation rate, C-reactive protein and D-dimer, lower level of hemoglobin, hematocrit, serum albumin, serum iron.

The gold standard of diagnosis of bone infection in the foot of patients with diabetes is sampling of bone, which is then subjected to both histopathologic and microbiological examination. The diabetic foot infection and nutritional status of the patients for more than one bone debridements and infected by more than one sorts of bacteria is more serious and poorer.