Therapeutic outcome of spinal implant infections caused by Staphylococcus aureus: A retrospective observational study

Spinal implant infection is a rare but significant complication of spinal fusion surgery, and the most common pathogen is Staphylococcus aureus. It is difficult to treat due to this pathogen's biofilm-forming ability and antibiotic resistance. We evaluated the therapeutic outcome of treatments...

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Published in:Medicine (Baltimore) 2018-10, Vol.97 (40), p.e12629-e12629
Main Authors: Cho, Oh-Hyun, Bae, In-Gyu, Moon, Song Mi, Park, Seong Yeon, Kwak, Yee Gyung, Kim, Baek-Nam, Yu, Shi Nae, Jeon, Min Hyok, Kim, Tark, Choo, Eun Ju, Lee, Eun Jung, Kim, Tae Hyong, Choi, Seong-Ho, Chung, Jin-Won, Kang, Kyung-Chung, Lee, Jung Hee, Lee, Yu-Mi, Lee, Mi Suk, Park, Ki-Ho
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - therapeutic use
Debridement - methods
Female
Humans
Male
Methicillin-Resistant Staphylococcus aureus
Middle Aged
Observational Study
Prosthesis-Related Infections - epidemiology
Prosthesis-Related Infections - therapy
Retrospective Studies
Rifampin
Risk Factors
Spinal Fusion - adverse effects
Spinal Fusion - statistics & numerical data
Staphylococcal Infections - epidemiology
Staphylococcal Infections - therapy
Staphylococcus aureus
Tertiary Care Centers
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Summary:Spinal implant infection is a rare but significant complication of spinal fusion surgery, and the most common pathogen is Staphylococcus aureus. It is difficult to treat due to this pathogen's biofilm-forming ability and antibiotic resistance. We evaluated the therapeutic outcome of treatments for S aureus spinal implant infections. We retrospectively reviewed all patients with S aureus spinal implant infections at 11 tertiary-care hospitals over a 9-year period. Parameters predictive of treatment failure and recurrence were analyzed by Cox regression. Of the 102 patients with infections, 76 (75%) were caused by methicillin-resistant S aureus (MRSA) and 51 (50%) were late-onset infections. In all, 83 (81%) patients were managed by debridement, antibiotics, and implant retention (DAIR) and 19 (19%) had their implants removed. The median duration of all antibiotic therapies was 52 days. During a median follow-up period of 32 months, treatment failure occurred in 37 (36%) cases. The median time to treatment failure was 113 days, being
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000012629