title: Effective treatment of post-spinal fusion methicillin-resistant Staphylococcus aureus vertebral osteomyelitis with linezolid in a renal-transplant patient.
abstract: BACKGROUND
  Methicillin-resistant Staphylococcus aureus (MRSA)-caused pyogenic spondylitis is a serious complication associated with lumbar fusion surgery. Often, anti-MRSA drugs are not used properly or patients discontinue drug use because of side effects including renal failure.
  
  
  METHODS
  We report a case at our hospital of a 54-year-old male renal-transplant patient who developed MRSA vertebral osteomyelitis after spinal fusion and was treated effectively with linezolid. After diagnosis of post-fusion surgery osteomyelitis, we conducted emergency flushing and debridement and began linezolid treatment (1200 mg/day, divided) immediately after the surgery. The level of C-reactive protein gradually decreased and became negative 4 weeks after the initiation of linezolid treatment. Serum creatinine level was approximately 1.3 mg/dL throughout the treatment period, indicating no deterioration in renal function.
  
  
  CONCLUSIONS
  These results suggest that early flushing and debridement together with linezolid administration is an effective treatment for MRSA vertebral osteomyelitis in renal-transplant patients.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. yundeatsushi@yahoo.co.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yunde
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. kazuhideinage@yahoo.co.jp.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Inage
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. sorita@chiba-u.jp.
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Orita
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. kyamauchi@chiba-u.jp.
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Yamauchi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. miyako_rush634@yahoo.co.jp.
authors.forename: Miyako
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of Orthopaedic Surgery, National Hospital Organization, Chiba Medical Center, Chiba, Japan. yoshihirosakuma@movie.ocn.ne.jp.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sakuma
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. gogogo@par.odn.ne.jp.
authors.forename: Go
authors.initials: G
authors.lastname: Kubota
authors.affiliation: Department of Orthopaedic Surgery, Chiba Children's Hospital, Chiba, Japan. y.oikawa-1979@hotmail.co.jp.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Oikawa
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. sain3005@yahoo.co.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sainoh
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. scottie6242000@yahoo.co.jp.
authors.forename: Jun
authors.initials: J
authors.lastname: Sato
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. s9082@nms.ac.jp.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Fujimoto
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. yshiga1111@yahoo.co.jp.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shiga
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. abeabeabe04@yahoo.co.jp.
authors.forename: Koki
authors.initials: K
authors.lastname: Abe
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. tukito_taiyo_emod@yahoo.co.jp.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Kanamoto
authors.affiliation: Department of Bioenvironmental Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan. takane.suzuki@faculty.chiba-u.jp.
authors.forename: Takane
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. 19501114@faculty.chiba-u.jp.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba City, Chiba, 260-8670, Japan. sohtori@faculty.chiba-u.jp.
authors.forename: Seiji
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mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D006801:Humans; D016030:Kidney Transplantation; D000069349:Linezolid / Q000627:therapeutic use*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology; D013123:Spinal Fusion; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D000069349:Linezolid