Mechanisms Underlying Bone Loss in Staphylococcus aureus Osteomyelitis

Osteomyelitis is commonly defined as a group of musculoskeletal infectious diseases caused by bacterial colonization of bone tissue, including implant-associated osteomyelitis, fracture-related infection, acute hematogenous osteomyelitis, and diabetic foot infection. Owing to differences in the underlying pathogenesis among these categories, the etiologic microorganisms also vary. Staphylococcus aureus is the most common and most destructive pathogen in skeletal infections. Epidemiological data from southwestern China indicate that approximately 20% of patients with osteomyelitis are diagnosed with S. aureus infection. In addition, the annual prevalence of S. aureus osteomyelitis in the United States is approximately 22 cases per 100,000 population, and its incidence has continued to increase over time. Ranging from asymptomatic skin colonization to life-threatening disease, this Gram-positive bacterium has evolved the capacity to infect virtually all human tissue types. Owing to its unique abilities to invade, colonize, and proliferate, S. aureus exhibits particularly high virulence in bone infections.