Methods: The study was approved by IRBs from all collaborating institutions. Inclusion criteria were adults (age ≥ 18 years) diagnosed with a spine infection, defined as an epidural abscess, vertebral osteomyelitis or discitis identified either by radiographic imaging or by operative procedure and treated with CFT for at least 28 days. Demographic, clinical and microbiological data were retrospectively and prospectively collected from electronic medical records. A control group of patients with spine infections was also identified. Descriptive statistics were used to analyze the data and characteristics were reported as mean and median values. Comparisons were made using the N-1 two-proportion test with a 2-tailed P value.
Results: There were 12 patients in the CFT group and 12 in the control group. The CFT and control groups were matched according to age (median 59 years; range 39 to 75 vs. 59 years; range 20 to 73), number of comorbidities (median 2.8; range 0 to 5 vs. 1.3; range 0 to 3) including IV drug abuse (2 vs. 3), and presence of underlying spinal prosthetic material at the time of infection (4 vs.1). In the CFT and control groups, the pathogens identified in tissue and/or bone cultures were MRSA (7 vs. 4), MSSA (1 vs. 2), coagulase negative Staphylococcus (2 vs.1), and “others” (1 vs. 3). Six patients in the CFT group were bacteremic with MRSA, while the control group had 3 cases of MRSA bacteremia and 3 cases of MSSA bacteremia. The number of days of IV therapy was comparable between the two groups (mean 45 days in the CFT group vs. 50 in the control group, P = 0.765). The number of CFT patients who received oral antibiotics after finishing IV therapy was similar to controls (3/12 vs. 4/12, respectively). Clinical success was achieved in all 12 CFT patients and in 11 of 12 controls. CFT was well tolerated with one adverse reaction (eosinophilic pneumonia) compared to one in the control group (fatigue and arthralgias from vancomycin).
Conclusion: In this early observational cohort, CFT was safe and effective therapy for spine infections including patients with MRSA and those with underlying prosthetic material.
R. R. Watkins,
N. Haller, None
R. A. Bonomo, None
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