Methods: We retrospectively included staphylococcal spinal implant infections at a 6 tertiary-care hospital over a 5-year period.
Results: We identified 75 patients with staphylococcal spinal implant infection. Of the 75 cases, 35 (47%) were early-onset infection and 40 (53%) were late-onset infection. Staphylococcus aureus was responsible for 58 (77%) cases and CoNS for 17 (33%) cases. Sixty (80%) isolates had methicillin resistance. Spinal implant was retained in 64 patients (85%) and was removed in 11 patients (15%). Of the 69 patients who completed initial course of antibiotic therapy, 24 (35%) experienced recurrence. The median time to recurrence after completing antibiotic therapy was 200 days (range, 65–997). Multivariate analysis indicated that independent predictors for recurrence included S. aureus infection (compared with CoNS, adjusted odds ratio [aOR], 8.25; 95% CI, 1.44–47.15; P = 0.01), <3 months of total antibiotic therapy (aOR, 6.14; 95% CI, 1.17–32.17; P = 0.03), and no concurrent rifampin therapy (aOR, 4.96; 95% CI, 1.16–21.28; P = 0.03). When analysis was repeated among 59 patients in whom spinal implant was retained, this analysis did not modify the results. Recurrence rate did not differ between early spinal implant infection and late spinal implant infection (36% [11/31] vs. 34% [13/34]; P= 0.91).
Conclusion: Thirty-five percent of our patients with staphylococcal spinal implant infection experienced recurrence. Prolonged duration (≥3 month) of total antibiotic therapy and concurrent rifampin therapy may be beneficial in patients with staphylococcal spinal implant infection, especially in those with their spinal implant retained.
K. H. Park,
I. G. Bae, None
B. N. Kim, None
S. H. Choi, None
J. W. Chung, None
Y. G. Kwak, None
S. Y. Park, None
M. S. Lee, None
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