806. The management and outcomes of spinal implant infections due to Staphylococcus aureus
Session: Poster Abstract Session: Bone and Joint
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Background: There are few data on the clinical characteristics and outcomes of spinal implant infections (SII) due to Staphylococcus aureus.

Methods: We performed a retrospective cohort study to evaluate risk factors for treatment failure in patients with SII due to S. aureus at three tertiary care hospitals in South Korea during 2004-2011. Staphylococcal implant infections were defined as the isolation of ≥ 1 strain of S. aureusfrom a reliable sample in the presence of clinical criteria. The rate of survival free of treatment failure was estimated using the Kaplan-Meier survival method.

Results: Forty patients were included in this study. The median age was 62 (range, 23-86) years. Methicillin-resistant S. aureus (MRSA) was identified in 29 (73%) cases.Twenty (50%) patients were diagnosed with SII within a month after implant insertion. Surgical management was performed in 28 (70%) cases including implant removal in 5 (13%) cases. The median duration of antimicrobial therapy was 58 (21-422) days. Rifampin based combination therapy was prescribed in 16 (40%) cases. The median follow-up duration was 614 (130-2232) days. Thirty-nine (98%) patients were sent the follow-up survey. Overall, 12 patients experienced treatment failure , with 2-year estimates of infection-free survival was 67% (95% CI, 58%-76%). The univariate analysis of risk factors for treatment failure showed that more than 3-month antibiotic therapy (P = 0.047) and rifampin based combination therapy (P= 0.044) was associated with increased cumulative probability of survival. SII due to MRSA was not associated with treatment failure.

Conclusion: This study suggests that long term antibiotic therapy for more than 3 months and rifampin based combination therapy may have contributed to the treatment of SII due to S. aureus.

Oh-Hyun Cho, MD1, Ki-Ho Park, MD2, Mingyo Kim, MD1, In-Gyu Bae, MD1, Myounghwa Jung, MD2, Sung-Han Kim, MD3, Sang-Oh Lee, MD3, Sang-Ho Choi, MD3, Yang Soo Kim, MD3, Jun Hee Woo, MD3 and Mi Suk Lee, MD2, (1)Department of Infectious Diseases, Gyeongsang National University Hospital, Jinju, South Korea, (2)Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea, (3)Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea


O. H. Cho, None

K. H. Park, None

M. Kim, None

I. G. Bae, None

M. Jung, None

S. H. Kim, None

S. O. Lee, None

S. H. Choi, None

Y. S. Kim, None

J. H. Woo, None

M. S. Lee, None

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