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Clinical characteristics and outcomes of hematogenous vertebral osteomyelitis caused by gram-negative bacteria.

Authors
 Ki Ho Park  ;  Oh Hyun Cho  ;  Myounghwa Jung  ;  Kyung Soo Suk  ;  Jung Hee Lee  ;  Ji Seon Park  ;  Kyung Nam Ryu  ;  Sung Han Kim  ;  Sang Oh Lee  ;  Sang Ho Choi  ;  In Gyu Bae  ;  Yang Soo Kim  ;  Jun Hee Woo  ;  Mi Suk Lee 
Citation
 Journal of Infection, Vol.69(1) : 42-50, 2014 
Journal Title
 Journal of Infection 
ISSN
 0163-4453 
Issue Date
2014
MeSH
Adolescent ; Adult ; Aged ; Anti-Bacterial Agents/therapeutic use* ; Bacteremia/complications* ; Cohort Studies ; Female ; Gram-Negative Bacterial Infections/drug therapy ; Gram-Negative Bacterial Infections/pathology* ; Humans ; Male ; Middle Aged ; Osteomyelitis/drug therapy ; Osteomyelitis/pathology* ; Prevalence ; Recurrence ; Retrospective Studies ; Spondylitis/drug therapy ; Spondylitis/pathology* ; Staphylococcal Infections/drug therapy ; Staphylococcal Infections/pathology ; Survival Analysis ; Tertiary Care Centers ; Treatment Outcome ; Young Adult
Keywords
Gram-negative bacteria ; Outcome ; Spondylitis ; Spondylodiscitis ; Vertebral osteomyelitis
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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0163445314000450
DOI
10.1016/j.jinf.2014.02.009
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Suk, Kyung Soo(석경수) ORCID logo https://orcid.org/0000-0003-0633-2658
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138538
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