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Bacteremic Staphylococcus aureus spondylitis

A G Jensen1, F Espersen, P Skinhøj

  • 1Sector for Microbiology, Statens Serum Institut, Copenhagen, Denmark.

Archives of Internal Medicine
|March 21, 1998
PubMed
Summary
This summary is machine-generated.

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Hematogenous Staphylococcus aureus vertebral osteomyelitis is increasing. Bone scans aid early diagnosis, and treatment with penicillinase-stable penicillins plus fusidic acid for 8 weeks is recommended for better outcomes.

Area of Science:

  • Infectious Diseases
  • Orthopedics
  • Radiology

Background:

  • Hematogenous Staphylococcus aureus osteomyelitis of the vertebral column is a growing concern.
  • Limited research exists on the diagnosis, treatment, and outcomes of this severe condition.

Purpose of the Study:

  • To review clinical and bacteriological data of vertebral osteomyelitis caused by S. aureus.
  • To evaluate diagnostic methods and treatment strategies for S. aureus vertebral osteomyelitis.

Main Methods:

  • Nationwide registration of 133 cases with S. aureus bacteremia and vertebral osteomyelitis (1980-1990).
  • Review of clinical, bacteriological, and diagnostic imaging data.

Main Results:

  • Infections were primarily community-acquired in older adults, often with comorbidities.

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  • Bone scans were superior to radiography for early diagnosis; infections commonly affected the lower spine.
  • Treatment duration and dosage influenced recurrence and failure rates; combination therapy with fusidic acid reduced recurrence.

    • Conclusions:

    • Clinical diagnosis of S. aureus vertebral osteomyelitis is challenging.
    • Bone scans are essential for early detection, surpassing conventional radiography.
    • Recommended treatment involves 8 weeks of penicillinase-stable penicillins (≥4 g/d) combined with fusidic acid.