Native Vertebral Osteomyelitis in Patients with Staphylococcus Aureus Bacteremia

Area of Science:

• Infectious Diseases
• Epidemiology
• Orthopedics

Background:

• Native vertebral osteomyelitis (NVO) is a serious complication in patients with Staphylococcus aureus bacteremia (SAB).
• Understanding the epidemiology and risk factors for NVO in SAB patients is crucial for improving outcomes.

Purpose of the Study:

• To assess the epidemiology, risk factors, and outcomes of NVO in patients with SAB.
• To identify specific patient characteristics and behaviors associated with NVO development.

Main Methods:

• Retrospective institutional review of patients aged ≥18 years with SAB and subsequent NVO from 2006-2020.
• Nested case-control analysis matched 1:2 for age, sex, and year of SAB diagnosis.
• Data abstracted included demographics, risk factors, comorbidities, and 3-month follow-up outcomes.

Main Results:

• 103 patients with NVO were identified; 60.2% were male, median age 62.0 years.
• Methicillin-resistant S. aureus (MRSA) caused 30.1% of cases; the lumbar spine was most commonly affected (57.6%).
• Injection drug use (IDU) and tobacco consumption were significant risk factors for NVO, while chronic hemodialysis and chronic liver disease (CLD) were associated with decreased risk.

Conclusions:

• Atherosclerotic vascular disease is prominent in contemporary NVO patients with SAB.
• Diabetes mellitus, tobacco use, older age, and male sex contribute to the NVO profile.
• Anticipate increased NVO cases among IDU patients due to the ongoing opioid epidemic.