Ki-Ho Park1, Oh Hyun Cho2, Myounghwa Jung1, Kyung-Soo Suk3, Jung Hee Lee4, Ji Seon Park5, Kyung Nam Ryu5, Sung-Han Kim6, Sang-Oh Lee6, Sang-Ho Choi6, In-Gyu Bae2, Yang Soo Kim6, Jun Hee Woo6, Mi Suk Lee7. 1. Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea. 2. Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Republic of Korea. 3. Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea. 4. Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Republic of Korea. 5. Department of Radiology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea. 6. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 7. Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, Republic of Korea. Electronic address: mslee@khmc.or.kr.
Abstract
OBJECTIVE: To evaluate the clinical characteristics and outcomes of patients with hematogenous vertebral osteomyelitis (HVO) caused by gram-negative bacteria (GNB). METHODS: We conducted a retrospective chart review of adult patients with HVO from three tertiary-care hospitals over a 7-year period. RESULTS: Of the 313 microbiologically diagnosed HVO cases, GNB was responsible for 65 (20.8%) cases. Compared with patients with MSSA HVO, patients with GNB HVO were more likely to be female (P = 0.03) and have diabetes (P = 0.03), but less likely to have epidural abscess (P = 0.02) and paravertebral abscess (P = 0.003). Clinical outcomes were similar between the GNB and MSSA groups, including in-hospital mortality (4.6% vs. 7.8%; P = 0.53), recurrence (9.7% vs. 4.3%; P = 0.20), and sequelae (31.7% vs. 32.2%; P = 0.95). Among GNB-infected patients, recurrence rates differed according to the total duration of antibiotic treatment: 40.0% (4-6 weeks), 33.3% (6-8 weeks), and 2.1% (≥ 8 weeks) (P = 0.002). CONCLUSIONS: GNB HVO was responsible for 20.8% of adult cases of HVO. Despite some differences in clinical and radiological presentation, clinical outcomes were similar between GNB and MSSA HVO. Antibiotic therapy for ≥ 8 weeks may benefit patients with GNB HVO.
OBJECTIVE: To evaluate the clinical characteristics and outcomes of patients with hematogenous vertebral osteomyelitis (HVO) caused by gram-negative bacteria (GNB). METHODS: We conducted a retrospective chart review of adult patients with HVO from three tertiary-care hospitals over a 7-year period. RESULTS: Of the 313 microbiologically diagnosed HVO cases, GNB was responsible for 65 (20.8%) cases. Compared with patients with MSSA HVO, patients with GNB HVO were more likely to be female (P = 0.03) and have diabetes (P = 0.03), but less likely to have epidural abscess (P = 0.02) and paravertebral abscess (P = 0.003). Clinical outcomes were similar between the GNB and MSSA groups, including in-hospital mortality (4.6% vs. 7.8%; P = 0.53), recurrence (9.7% vs. 4.3%; P = 0.20), and sequelae (31.7% vs. 32.2%; P = 0.95). Among GNB-infectedpatients, recurrence rates differed according to the total duration of antibiotic treatment: 40.0% (4-6 weeks), 33.3% (6-8 weeks), and 2.1% (≥ 8 weeks) (P = 0.002). CONCLUSIONS: GNB HVO was responsible for 20.8% of adult cases of HVO. Despite some differences in clinical and radiological presentation, clinical outcomes were similar between GNB and MSSA HVO. Antibiotic therapy for ≥ 8 weeks may benefit patients with GNB HVO.
Authors: Elena Lazzeri; Alessandro Bozzao; Maria Adriana Cataldo; Nicola Petrosillo; Luigi Manfrè; Andrej Trampuz; Alberto Signore; Mario Muto Journal: Eur J Nucl Med Mol Imaging Date: 2019-08-09 Impact factor: 9.236
Authors: F Javier Fonseca Del Pozo; Joaquín Valle Alonso; Miguel Ángel Caracuel Ruiz; Siyamini Vythilingam; Daniel Lopez Ruiz Journal: Bull Emerg Trauma Date: 2016-07