• Sharon Weissman, R David Parker, Wajid Siddiqui, Shana Dykema, and Joseph Horvath.
• From the School of Medicine, University of South Carolina , Columbia, South Carolina.
• Scand. J. Infect. Dis. 2014 Mar 1; 46 (3): 193-9.

IntroductionInfectious vertebral osteomyelitis (VO) is a significant source of morbidity that can lead to chronic sequelae. The objectives of this study were to describe the clinical presentations and assess the outcomes of VO.MethodsA retrospective review of cases of VO admitted to an inpatient service between 1 January 2000 and 31 March 2012 was carried out. Cases had evidence of VO by clinical syndrome, imaging, histopathology, and/or microbiology. Outcomes assessed were implantation of prosthetic material for stabilization, hospital readmission for management of VO, repeat surgical intervention, and additional or prolonged courses of antibiotics.ResultsOf 117 VO cases, a causative organism was identified in the majority (88.0%). Staphylococcus aureus was the most common organism isolated, followed by Streptococcus species. The most common infection site was the lumbar spine (55.5%). Surgical intervention was required in 81.2% of cases. Infections involving the lumbar vertebrae were associated with a higher risk of all 4 outcomes. Individuals with methicillin-resistant S. aureus infection were more likely to require a readmission for management of VO (odds ratio (OR) 3.94, 95% confidence interval (CI) 1.25-12.42). Individuals with lumbar infections were more likely to require additional antibiotics (OR 4.08, 95% CI 1.34-12.40) and more likely to require readmission (OR 8.29, 95% CI 1.84-37.33) for management of VO. An early infectious disease consultation was associated with a decreased risk for additional antibiotics (OR 0.30, 95% CI 0.11-0.83).ConclusionsVO was frequently caused by S. aureus or Streptococcus species. Most cases required surgical intervention. An early infectious disease consult ensured a more appropriate antibiotic course.

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