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. 2020 May 20;7(6):ofaa176.
doi: 10.1093/ofid/ofaa176. eCollection 2020 Jun.

Microbial Etiology of Pyogenic Vertebral Osteomyelitis According to Patient Characteristics

Dong Youn Kim  1 , Uh Jin Kim  2 , Yohan Yu  2 , Seong-Eun Kim  2 , Seung-Ji Kang  2 , Kang-Il Jun  1 , Chang Kyung Kang  1 , Kyoung-Ho Song  1 , Pyoeng Gyun Choe  1 , Eu Suk Kim  1 , Hong Bin Kim  1 , Hee-Chang Jang  2 , Sook In Jung  2 , Myoung-Don Oh  1 , Kyung-Hwa Park  2 , Nam Joong Kim  1
Affiliations

Microbial Etiology of Pyogenic Vertebral Osteomyelitis According to Patient Characteristics

Dong Youn Kim et al. Open Forum Infect Dis. .

Abstract

Background: It is difficult to select an appropriate empirical antibiotic treatment regimen for patients with culture-negative pyogenic vertebral osteomyelitis (PVO). Having knowledge of the distribution of microorganisms according to patient characteristics can help clinicians make informed choices regarding empirical antibiotics. The aim of this study was to determine the microbial distribution among individuals with PVO according to their demographic and clinical characteristics.

Methods: We reviewed the medical records of patients admitted to our hospital with culture-confirmed PVO between January 2005 and December 2017 and collected data on demographics, underlying diseases, and radiographic and microbiological results. Statistical analysis was performed to identify associations between specific bacteria and specific patient characteristics.

Results: A total of 586 patients were included in the study. The prevalence of Staphylococcus aureus infections was higher in young patients than in old patients, while gram-negative bacterial infections and Enterococcus were more prevalent in older patients. Gram-negative bacterial infections were more common in women than in men (32.1% vs 16.4%; P < .05), in patients with cirrhosis than in those without (32.7% vs 21.1%; P < .05), and in patients with a solid tumor than in those without (31.0% vs 20.7%; P < .05). Methicillin-resistant S. aureus infections were more prevalent in patients with chronic renal disease than in those without (34.4% vs 14.7%; P < .05).

Conclusions: The microbial etiology of PVO varies according to patient characteristics. Patient characteristics should thus be considered when choosing empirical antibiotics in patients with culture-negative PVO.

Keywords: Staphylococcus aureus; chronic renal insufficiency; gram-negative bacteria; spondylitis; vertebral osteomyelitis.

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Figures

Figure 1.
Figure 1.
Microbial etiology of pyogenic vertebral osteomyelitis according to age (A), sex (B), and spinal level (C).
See this image and copyright information in PMC

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