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Microbial etiology of vertebral osteomyelitis/discitis amid the opioid epidemic
S Alexander Ammerman1,2, Alexander Keister1,2, Joshua Vignolles-Jeong1,2
11The Ohio State University College of Medicine, Columbus.
Objective:
The primary goal of this study was to establish the current microbial trends in vertebral osteomyelitis/discitis (VOD) amid the opioid epidemic and to determine if intravenous drug use (IVDU) predisposes one to a unique microbial profile of infection.
Methods:
The authors performed a retrospective cohort study consisting of 1175 adult patients diagnosed with VOD between 2011 and 2022 at a single quaternary center. Data were acquired through retrospective chart review, with pertinent demographic and clinical information collected.
Results:
Staphylococcus aureus was the most cultured organism in both the IVDU and non-IVDU groups at 56.1% and 40.7%, respectively. In the IVDU cohort, Serratia marcescens was the next most prevalently cultured organism at 13.9%.
Conclusions:
The present study demonstrates that in the IVDU population S. marcescens is an organism of high concern. The potential for Serratia spp. infection should be accounted for when selecting empirical antimicrobial therapy in VOD patients.
Insights
Intravenous drug use (IVDU) is linked to unique microbial trends in vertebral osteomyelitis/discitis (VOD). Serratia marcescens is a significant concern in IVDU patients, requiring consideration in empirical antimicrobial therapy.
Area of Science:
- Infectious Diseases
- Orthopedics
- Microbiology
Background:
- Vertebral osteomyelitis/discitis (VOD) is a serious spinal infection.
- The opioid epidemic has led to an increase in healthcare-associated infections, including VOD.
- Intravenous drug use (IVDU) is a known risk factor for VOD.
Purpose of the Study:
- To investigate current microbial trends in VOD.
- To determine if IVDU is associated with a distinct microbial profile in VOD.
- To inform empirical antimicrobial treatment strategies for VOD.
Main Methods:
- Retrospective cohort study of 1175 adult VOD patients (2011-2022).
- Data collected via retrospective chart review at a single quaternary center.
- Comparison of microbial profiles between IVDU and non-IVDU cohorts.
Main Results:
- Staphylococcus aureus was the most common organism in both groups (56.1% IVDU, 40.7% non-IVDU).
- Serratia marcescens was the second most prevalent organism in the IVDU cohort (13.9%).
- A unique microbial profile was observed in the IVDU population.
Conclusions:
- Serratia marcescens is a significant pathogen in VOD among IVDU patients.
- Antimicrobial therapy for VOD should consider Serratia spp. in IVDU populations.
- Understanding microbial trends is crucial for effective VOD management.
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