Outcomes of treatment for hematogenous Staphylococcus aureus vertebral osteomyelitis in the MRSA ERA

Daniel J. Livorsi, Naval G. Daver, Robert L. Atmar, Samuel A. Shelburne, A. Clinton White, Daniel M. Musher

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48 Scopus citations


Objectives: Hematogenous vertebral osteomyelitis is caused predominantly by Staphylococcus aureus. The rise in incidence of methicillin-resistant S. aureus (MRSA) has complicated the treatment of this infection. Our objective was to evaluate therapeutic outcomes for S. aureus vertebral osteomyelitis in a setting of high MRSA prevalence. Methods: We conducted a retrospective chart review of all patients who presented with S. aureus vertebral osteomyelitis over a 7-year period at 2 tertiary care hospitals in Houston, TX, USA. Results: Thirty-five patients were identified who received ≥2-week course of parenteral antibiotics and had a follow-up period of at least 12 months post-therapy. MRSA was responsible for 20 (57%) cases. Mean duration of total antibiotic therapy was 61.4 days. The overall relapse rate was 14%. At 12 months post-therapy, 86% patients were cured. The one factor significantly associated with relapse was presence of undrained abscesses (p = 0.04). Conclusions: When the mean duration of effective antibiotic therapy was 60 days, cure rates for S. aureus vertebral osteomyelitis exceeded 80%. Drainage of all associated abscesses correlated with a significantly higher rate of cure.

Original languageEnglish (US)
Pages (from-to)128-131
Number of pages4
JournalJournal of Infection
Issue number2
StatePublished - Aug 2008


  • Abscess
  • Staphylococcus aureus
  • Vertebral osteomyelitis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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