Clinical characteristics of pyogenic vertebral osteomyelitis, and factors associated with inadequate treatment response
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Clinical characteristics of pyogenic vertebral osteomyelitis, and factors associated with inadequate treatment response. / Geisler Crone, Cornelia; Mose Tetens, Malte; Bengaard Andersen, Aase; Obel, Niels; Lebech, Anne Mette.
I: International Journal of Infectious Diseases, Bind 108, 2021, s. 487-493.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Clinical characteristics of pyogenic vertebral osteomyelitis, and factors associated with inadequate treatment response
AU - Geisler Crone, Cornelia
AU - Mose Tetens, Malte
AU - Bengaard Andersen, Aase
AU - Obel, Niels
AU - Lebech, Anne Mette
N1 - Publisher Copyright: © 2021 Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet
PY - 2021
Y1 - 2021
N2 - Objectives: Pyogenic vertebral osteomyelitis (PVO) is associated with a high burden of disease. Our study aimed to describe characteristics at presentation of PVO, the risk of inadequate treatment response (ITR), relapse, and death, and to determine risk factors for ITR. Methods: Patients with an ICD-10 discharge code for PVO and admission to a major Danish university hospital between November 2016 and April 2019 were included. ITR was defined as clinical, microbiological, and/or radiological progression during treatment. Data were collected through review of medical records, and logistic regression was used to determine adjusted odds ratios (aOR). Results: Of 106 patients included, 87% presented with pain in the spine, 97% elevated CRP, 14% severe sepsis, and 13% with a history of previous spinal surgery. 39% were infected with Staphylococcus aureus and 9% with Escherichia coli. 31% responded inadequately to treatment, and risk factors for ITR were previous spinal surgery (aOR 19.29; 95% confidence interval (CI) 2.20–169.08), severe sepsis (aOR 4.59; 95% CI 1.28–15.41), and infection with Escherichia coli (aOR 8.10; 95% CI 1.71–38.45). 13% experienced relapse within the first 2 years, while the 1-year crude mortality was 12%. Conclusion: Staphylococcus aureus is still the main pathogen in PVO patients, and the risks of relapse and mortality remain high. Factors found to be associated with ITR were previous spinal surgery, severe sepsis, and infection with Escherichia coli.
AB - Objectives: Pyogenic vertebral osteomyelitis (PVO) is associated with a high burden of disease. Our study aimed to describe characteristics at presentation of PVO, the risk of inadequate treatment response (ITR), relapse, and death, and to determine risk factors for ITR. Methods: Patients with an ICD-10 discharge code for PVO and admission to a major Danish university hospital between November 2016 and April 2019 were included. ITR was defined as clinical, microbiological, and/or radiological progression during treatment. Data were collected through review of medical records, and logistic regression was used to determine adjusted odds ratios (aOR). Results: Of 106 patients included, 87% presented with pain in the spine, 97% elevated CRP, 14% severe sepsis, and 13% with a history of previous spinal surgery. 39% were infected with Staphylococcus aureus and 9% with Escherichia coli. 31% responded inadequately to treatment, and risk factors for ITR were previous spinal surgery (aOR 19.29; 95% confidence interval (CI) 2.20–169.08), severe sepsis (aOR 4.59; 95% CI 1.28–15.41), and infection with Escherichia coli (aOR 8.10; 95% CI 1.71–38.45). 13% experienced relapse within the first 2 years, while the 1-year crude mortality was 12%. Conclusion: Staphylococcus aureus is still the main pathogen in PVO patients, and the risks of relapse and mortality remain high. Factors found to be associated with ITR were previous spinal surgery, severe sepsis, and infection with Escherichia coli.
KW - Discitis
KW - Pyogenic
KW - Spinal infection
KW - Spondylodiscitis
KW - Vertebral osteomyelitis
U2 - 10.1016/j.ijid.2021.05.078
DO - 10.1016/j.ijid.2021.05.078
M3 - Journal article
C2 - 34091001
AN - SCOPUS:85109215313
VL - 108
SP - 487
EP - 493
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
SN - 1201-9712
ER -
ID: 274618173