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- Title
Influence of microbiological diagnosis on the clinical course of spondylodiscitis.
- Authors
Stangenberg, Martin; Mende, Klaus Christian; Mohme, Malte; Krätzig, Theresa; Viezens, Lennart; Both, Anna; Rohde, Holger; Dreimann, Marc
- Abstract
Purpose: This study sought to recognize differences in clinical disease manifestations of spondylodiscitis depending on the causative bacterial species. Methods: We performed an evaluation of all spondylodiscitis cases in our clinic from 2013–2018. 211 patients were included, in whom a causative bacterial pathogen was identified in 80.6% (170/211). We collected the following data; disease complications, comorbidities, laboratory parameters, abscess occurrence, localization of the infection (cervical, thoracic, lumbar, disseminated), length of hospital stay and 30-day mortality rates depending on the causative bacterial species. Differences between bacterial detection in blood culture and intraoperative samples were also recorded. Results: The detection rate of bacterial pathogens through intraoperative sampling was 66.3% and could be increased by the results of the blood cultures to a total of 80.6% (n = 170/211). S. aureus was the most frequently detected pathogen in blood culture and intraoperative specimens and and was isolated in a higher percentage cervically than in other locations of the spine. Bacteremic S. aureus infections were associated with an increased mortality (31.4% vs. overall mortality of 13.7%, p = 0.001), more frequently developing complications, such as shock, pneumonia, and myocardial infarction. Comorbidities, abscesses, length of stay, sex, and laboratory parameters all showed no differences depending on the bacterial species. Conclusion: Blood culture significantly improved the diagnostic yield, thus underscoring the need for a structured diagnostic approach. MSSA spondylodiscitis was associated with increased mortality and a higher incidence of complications.
- Subjects
DIAGNOSIS of bacterial diseases; CERVICAL vertebrae; LENGTH of stay in hospitals; BLOOD; SURGICAL therapeutics; PNEUMONIA; CELL culture; ABSCESSES; BLOOD collection; SHOCK (Pathology); MYOCARDIAL infarction; STAPHYLOCOCCAL diseases; DESCRIPTIVE statistics; STAPHYLOCOCCUS aureus; DISCITIS; BACTERIAL diseases; LUMBAR vertebrae; COMORBIDITY; THORACIC vertebrae; SYMPTOMS; DISEASE complications
- Publication
Infection, 2021, Vol 49, Issue 5, p1017
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-021-01642-5