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Michael E. DeBakey VA Medical Center - Houston, Texas

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Journal Article Reveals Spinal Epidural Infections on the Rise

November 20, 2006

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Veteran Howard Atkinson discusses treatment options with Rabih O. Darouiche, M.D. a staff physician in the Medical and Spinal Cord Injury Care Lines.
PHOTO: Bobbi D. Gruner, MEDVAMC Public Affairs Officer


HOUSTON – Infections in the space around the spinal cord have increased over the past decade and many are associated with antibiotic-resistant bacteria, according to a review that appeared in the November 9, 2006 issue of the New England Journal of Medicine by Rabih O. Darouiche, M.D., staff physician, Michael E. DeBakey VA Medical Center (MEDVAMC).

The article notes abscesses caused by Methicillin-Resistant Staphylococcus aureus (MRSA) are increasingly the cause of such infections. “However, what was most significant and alarming was the fact that the majority of cases continue to be misdiagnosed upon initial presentation,” said Darouiche.

MRSA is a more serious form of a common bacteria that frequently inhabits the skin or nostrils of healthy people. Due to its resistance to antibiotics commonly used in treatment, MRSA is one of the most rapidly growing and virulent health care associated infections, and according to the Centers for Disease Control and Prevention (CDC), is responsible for more than 100,000 U.S. hospitalizations each year.

The most common sources of spinal epidural infection include bloodstream infection associated with a central venous catheter, intravenous drug use, catheter-related urinary tract infection, vertebral osteomyelitis, spinal catheter for pain relief or stimulation, and infected pressure sores.

“Treatment of patients with this type of infection requires well-coordinated multidisciplinary care by emergency medicine physicians, hospitalists, internists, infectious-disease physicians, neurologists, neurosurgeons, orthopedic surgeons, nurses, and physical and occupational therapists,” said Darouiche.

Darouiche, a staff physician in the Medical Care and Spinal Cord Injury Care Lines at the MEDVAMC, is also the founder and director of the Center for Prostheses Infection of Baylor College of Medicine. He is board certified in internal medicine, infectious disease, and spinal cord injury medicine.

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