Methods: A retrospective study of SEA cases at an academic teaching hospital was conducted using data from 2005-2012. Data collected included sociodemographic factors; medical conditions; causative organism; laboratory data; radiographic imaging; suspected mechanism for development (surgery vs. spinal injection vs. bacteremia); treatment; and outcome.
Results: A total of 103 SEA cases (incidence of 3.9 cases/10,000 admissions) were documented with no significant change in the incidence of cases over the study period. The median age was 58 years, 74% were males, and 90% were white or Hispanic. Location of the SEA was C-spine (15%), T- (17%), L- (50%), and multiple levels (18%). IVDU was noted in 19%, 8% had a preexisting central line; 75% had at least one other underlying medical condition. A causative organism was identified in 77% of cases based on cultures of blood (33%), abscess (30%), or both (37%). The most common identified cause of SEA was Staphylococcus (64%). Other GPCs were identified in 13%, gram-negatives in 14%, and there was one case of brucellosis. Bacteremia was the leading diagnosed route of infection (64%), followed by surgery (26%) and spinal injection (11%). There was no relationship between causative organism and manner of introduction. Over time there was a reduction in the cases linked to spinal injections. All cases received antibiotics (median duration of IV therapy was 8 weeks) and 52% underwent surgery. Lingering neurologic deficits were noted in 8%.
Conclusion: We report one of the largest contemporary series of SEA. Our data found a high incidence of SEA with a