title: Increasing incidence of pyogenic spondylodiscitis: a 14-year population-based study.
abstract: OBJECTIVE
  Smaller studies indicate that the incidence of pyogenic spondylodiscitis is increasing, possible related to a growing elderly population. Data supporting this is sparse, and we therefore studied patient characteristics and changes in spondylodiscitis incidence 1995-2008.
  
  
  METHODS
  In a population-based study we identified all patients aged ≥18 years treated for pyogenic spondylodiscitis in Funen County, Denmark (population 483 123). Annual incidences were determined. Demographics, symptoms and diagnostic methods were recorded.
  
  
  RESULTS
  We found 192 cases: median age 66.6 years; 57.3% men; 76.6% culture positive cases. Staphylococcus aureus was the most common pathogen (55.1%). During 1995-2008 the overall incidence, incidence of culture negative cases, and incidence of cases due to S. aureus increased 2.2-5.8, 0.3-1.8, and 1.6-2.5 cases per 100 000 person years, respectively. The elderly had the highest incidence compared to those aged ≤70 years (rate ratio for men 5.9 (95% CI: 4.2-8.5) and for women 3.5 (95% CI: 2.3-5.3)).
  
  
  CONCLUSIONS
  During 1995-2008 the overall incidence of S. aureus and culture negative cases of spondylodiscitis increased and remained highest among the elderly. Whether the increase is real or is a result of improved diagnostic methods and workup remains unknown.
authors.affiliation: Institute of Clinical Research, University of Southern Denmark, Winsløwparken 19/3, 5000 Odense C, Denmark; Department of Infectious Diseases, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense, Denmark. Electronic address: michala.kehrer@rsyd.dk.
authors.forename: Michala
authors.initials: M
authors.lastname: Kehrer
authors.affiliation: Institute of Clinical Research, University of Southern Denmark, Winsløwparken 19/3, 5000 Odense C, Denmark; Department of Infectious Diseases, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense, Denmark.
authors.forename: Court
authors.initials: C
authors.lastname: Pedersen
authors.affiliation: Department of Clinical Microbiology, Odense University Hospital, J.B. Winsløwsvej 21/2, 5000 Odense, Denmark.
authors.forename: Thøger G
authors.initials: TG
authors.lastname: Jensen
authors.affiliation: Institute of Clinical Research, University of Southern Denmark, Winsløwparken 19/3, 5000 Odense C, Denmark; Department of Emergency Medicine, Odense University Hospital Odense, Sdr. Boulevard 29, 5000 Odense, Denmark.
authors.forename: Annmarie T
authors.initials: AT
authors.lastname: Lassen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D003718:Denmark / Q000453:epidemiology; D015299:Discitis / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: Epidemiology; Incidence; Patient characteristics; Population-based; Pyogenic spondylodiscitis; Vertebral osteomyelitis