Variables associated with remission in spinal surgical site infections.
BACKGROUND
There is few medical literature regarding factors associated with remission after surgical and medical treatment of postoperative spine infections.


METHODS
Single-centre case-control study 2007-2014. Cluster-controlled Cox regression model with emphasis on surgical and antibiotic-related parameters.


RESULTS
Overall, we found 66 episodes in 48 patients (49 episodes with metalwork) who had a median follow-up of 2.6 years (range, 0.5 to 6.8 years). The patients had a median of two surgical debridements. The median duration of antibiotic therapy was 8 weeks, of which 2 weeks parenteral. Clinical recurrence after treatment was noted in 13 episodes (20%), after a median interval of 2 months. In 53 cases (80%), the episodes were considered as in remission. By multivariate analyses, no variable was associated with remission. Especially, the following factors were not significantly related to remission: number of surgical interventions [hazard ratio (HR) 0.9; 95% confidence interval (CI), 0.8-1.1]; infection due to Staphylococcus aureus (HR 0.9; 0.8-1.1), local antibiotic therapy (HR 1.2; 0.6-2.4), and, duration of total (HR 1.0; 0.99-1.01) (or just parenteral) (HR 1.0; 0.99-1.01) antibiotic use.


CONCLUSIONS
In patients with post-operative spine infections, remission is achieved in 80%. The number of surgical debridement or duration of antibiotic therapy shows no association with recurrence, suggesting that individual risk factors might be more important than the duration of antibiotic administration.
Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
Julien
J
Billières
Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland; Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland.
Ilker
I
Uçkay
Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
Antonio
A
Faundez
Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
Jonathan
J
Douissard
Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
Paulina
P
Kuczma
Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
Domizio
D
Suvà
Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
Mathieu
M
Zingg
Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
Pierre
P
Hoffmeyer
Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
Dennis E
DE
Dominguez
Division of Orthopaedics and Trauma Surgery, Geneva University Hospitals, Geneva, Switzerland.
Guillaume
G
Racloz
Spine surgery; antibiotic therapy; associations; infection cure; surgery
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