Optimizing pathogen detection in skull base osteomyelitis: a comparative analysis of swab versus biopsy sampling.

PURPOSE: SBO is a potentially life-threatening condition requiring multimodal treatment. For targeted antibiotic therapy, identification of the causative pathogen is essential. This paper aims to compare biopsy and swab techniques and assess their impacts on the initiation and adequacy of antibiotic therapy.

METHODS

A retrospective analysis was conducted on 56 adult patients treated for SBO 2008-2025. This study focuses on comparing intraoperative swab and biopsy specimens versus non-intraoperative swab specimens.

RESULTS

The most frequently detected organism in patients with typical SBO was Pseudomonas aeruginosa, accounting for 28.0% isolates from external auditory canal swabs and 23.7% of isolates from biopsy sites (patients with atypical SBO: 78.6%). Despite comprehensive sampling no microbiological pathogen could be isolated in 16.1% of patients.

CONCLUSION

Pathogen-specific antibiotic therapy following tissue sampling is a cornerstone of SBO treatment. Accordingly, appropriate specimen collection plays a key role in selecting the correct antibiotic therapy.