{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T23:57:11Z","timestamp":1791158231470,"version":"4.1.0"},"reference-count":29,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare clinical features and outcomes between culture-positive and culture-negative vertebral osteomyelitis (VO), describe empirical antimicrobial regimens used for culture-negative VO, and identify independent predictors of 1-year recurrence and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 252 consecutive patients treated for VO at a tertiary center (2010\u20132023). Finally, 206 patients were analyzed (173 culture-positive, 33 culture-negative). Demographics, comorbidities, laboratory and imaging findings, microbiology, antimicrobial regimens, and surgical treatment were collected. Antimicrobials were generally administered for \u22656 weeks. Primary outcomes were initial treatment failure, recurrence, 1-year all-cause mortality, and infection-related mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Culture-negative VO showed lower temperature, C-reactive protein, and white blood cell count; higher albumin; and fewer epidural abscesses than culture-positive VO, consistent with a milder phenotype. Initial treatment failure and recurrence occurred in 24\/206 (11.7%) and 3\/206 (1.5%) patients, respectively. All recurrences occurred in the culture-positive group. One-year all-cause mortality was 17% (29\/173) in culture-positive and 24% (8\/33) in culture-negative patients (p=0.305); infection-related mortality was 13% and 18%, respectively (p=0.424). Among culture-negative patients, outcomes did not differ between cefazolin-based versus other empirical regimens. Multivariable analysis identified older age, higher Charlson Comorbidity Index, hypoalbuminemia, and absence of surgery as independent predictors of mortality, whereas culture status was not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cohort with high microbiological yield (84%), culture-negative VO presented with milder clinical features and had recurrence and 1-year mortality comparable to culture-positive VO when treated with \u22656 weeks of antimicrobials. Prognosis was driven primarily by host factors rather than culture status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261464162","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T14:59:03Z","timestamp":1782485943000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Culture Status on Outcomes in Vertebral Osteomyelitis: A Retrospective Cohort Study of 206 Patients"],"prefix":"10.1177","author":[{"given":"Daiki","family":"Sako","sequence":"first","affiliation":[{"name":"Kobe City Medical Center General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yushi","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Kobe City Medical Center General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Ota","sequence":"additional","affiliation":[{"name":"Kobe City Medical Center General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisataka","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Kobe City Medical Center General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Tsukamoto","sequence":"additional","affiliation":[{"name":"Kobe City Medical Center General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinnosuke","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Kobe City Medical Center General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Honjo","sequence":"additional","affiliation":[{"name":"Kobe City Medical Center General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaya","family":"Kubota","sequence":"additional","affiliation":[{"name":"Kobe City Medical Center General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Tanimoto","sequence":"additional","affiliation":[{"name":"Kobe City Medical Center General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6766-5512","authenticated-orcid":false,"given":"Sadaki","family":"Mitsuzawa","sequence":"additional","affiliation":[{"name":"Kobe City Medical Center General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Kobe City Medical Center General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9936-555X","authenticated-orcid":false,"given":"Eijiro","family":"Onishi","sequence":"additional","affiliation":[{"name":"Kobe City Medical Center General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2008.03.002"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ482"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.3947\/IC.2021.0054"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac616"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13195802"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000001866"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2014.04.008"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-05669-1"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/02688697.2021.1896677"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-018-3467-2"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61233-2"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-015-4318-y"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/CID\/CIW098"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.3947\/ic.2019.51.3.274"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2021.04.001"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682251317136"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-026-12549-7"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.06.021"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1086\/340102"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2020.08.005"},{"key":"e_1_3_7_23_2","unstructured":"Lee JH Song S Son DW Choi K. 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