• B Castagné, M Soubrier, J Prouteau, N Mrozek, O Lesens, A Tournadre, E Gadea, and M Vidal.
• Service de médecine interne, centre hospitalier Émile-Roux, 12, boulevard Dr André-Chantemesse, 43000 Le Puy-en-Velay, France. Electronic address: benjamin.castagne@ch-lepuy.fr.
• Med Mal Infect. 2021 May 1; 51 (3): 253-259.

BackgroundWe compared the relapse rate at 1 year in patients with vertebral osteomyelitis with or without associated endocarditis.Patients And MethodsWe conducted a retrospective cohort study. Inclusion criteria were patients hospitalized in the infectious disease, rheumatology, cardiology, cardiovascular surgery and two internal medicine units for vertebral osteomyelitis (blood culture and/or disco-vertebral biopsy) and compatible imaging, between 2014 and 2017. We compared patients with associated endocarditis (VO-EI group) and without endocarditis (VO group) using logistic regression to determine the factors associated with relapse and EI. The main outcome was the relapse rate at 1 year.ResultsOut of the 207 eligible patients, 62 were included (35 in the VO group and 27 in the VO-EI group). Four patients presented with a new VO during follow-up, one (2.86%) patient in VO group and three (11.11%) in VO-EI group (P=0.68). There were more men in the VO-EI group than in the VO group (74.07% vs. 48.57%, P=0.04), valvulopathies (13/27 vs. 8/35, P=0.06), vertebral localization (1.22±0.50 vs. 1.03±0.17, P=0.04) and septic kidney embolism (5/27 vs. 0/35, P=0.01). Control blood cultures were more often positive in the VO-EI group (12/27 vs. 8/35, P=0.04). In 45% of patients, the germ was a staphylococcus, 29% streptococci, 10% enterococci, 10% gram-negative bacillus (GNB). There were more streptococci and enterococci in the VO-EI group than in the VO group (44.44% vs. 17.14% and 18.52% vs. 8.57%, respectively). Antibiotic safety was good and comparable between groups.ConclusionIn a relatively small population, we did not find significantly more relapse in the endocarditis group.Copyright © 2020 Elsevier Masson SAS. All rights reserved.

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