Increasing incidence of pyogenic spondylodiscitis: a 14-year population-based study

J Infect. 2014 Apr;68(4):313-20. doi: 10.1016/j.jinf.2013.11.011. Epub 2013 Dec 1.

Abstract

Objectives: 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.

Keywords: Epidemiology; Incidence; Patient characteristics; Population-based; Pyogenic spondylodiscitis; Vertebral osteomyelitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Bacterial Infections / diagnosis
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / pathology
  • Denmark / epidemiology
  • Discitis / diagnosis
  • Discitis / epidemiology*
  • Discitis / pathology
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Young Adult