1549. Therapeutic Outcomes of Staphylococcal Spinal Implant Infections
Session: Poster Abstract Session: Clinical Infectious Diseases: Prosthetic Joint Infections
Saturday, October 10, 2015
Room: Poster Hall
Background: Spinal implant infection is one of the most significant complications of spinal fusion surgery and most common causative organisms of this infection were Staphylococcus aureus and coagulase-negative staphylococci (CoNS). Considering the difficulties in treating biofilm-associated staphylococcal infections, the use of biofilm-active agent such as rifampin may be useful for treating staphylococcal spinal implant infection. The aim of this study is to evaluate therapeutic outcome of staphylococcal spinal implant infections.

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.

Ki-Ho Park, MD1, Oh-Hyun Cho, MD2, In-Gyu Bae, MD2, Baek-Nam Kim, MD3, Seong-Ho Choi, MD4, Jin-Won Chung, MD4, Yee Gyung Kwak, MD5, Seong Yeon Park, MD6 and Mi Suk Lee, MD, PhD1, (1)Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, South Korea, (2)Division of Infectious Diseases, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea, (3)Inje University Paik Hospital, Seoul, South Korea, (4)Department of Internal Medicine, Chung-Ang University Medical Center, Seoul, South Korea, (5)Department ofInfectiousDiseases,InjeUniversityIlsanPaikHospital, Goyang, South Korea, (6)Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, South Korea

Disclosures:

K. H. Park, None

O. H. Cho, None

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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