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Microbiology and antimicrobial therapy of spinal infections

F L Sapico1

  • 1Department of Medicine, University of Southern California, Los Angeles, USA.

The Orthopedic Clinics of North America
|January 1, 1996
PubMed

Insights

Hematogenous vertebral osteomyelitis (VO) is typically a single-bacterial infection, often caused by S. aureus. Treatment involves high-dose antibiotics and surgery, with ESR guiding therapy duration.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Microbiology

Background:

  • Hematogenous vertebral osteomyelitis (VO) predominantly affects older adults.
  • Staphylococcus aureus is the most common pathogen.
  • Gram-negative bacilli are associated with urinary tract infections and intravenous drug abuse (IVDA).

Purpose of the Study:

  • To review the microbiology and treatment of vertebral osteomyelitis.
  • To discuss diagnostic methods and therapeutic strategies.
  • To highlight the role of ESR in guiding treatment.

Main Methods:

  • Review of existing literature on vertebral osteomyelitis.
  • Analysis of causative microorganisms and their sources.
  • Evaluation of antimicrobial therapy and surgical interventions.

Main Results:

  • Monomicrobial infections are typical, with S. aureus being most frequent.
  • Gram-negative bacilli are observed in specific patient groups (elderly males, IVDA).
  • Diagnosis often involves needle or open surgical biopsy.

Conclusions:

  • Vertebral osteomyelitis requires parenteral antibiotics and potential surgical intervention.
  • Erythrocyte Sedimentation Rate (ESR) is a key indicator for monitoring treatment response.
  • Prolonged therapy may be needed for persistent infection or abscesses.

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