The importance of the bacterial spectrum in the clinical diagnostics and management of patients with spontaneous pyogenic spondylodiscitis and isolated spinal epidural empyema: a 20-year cohort study at a single spine center

• Published in: BMC infectious diseases 2024-01, Vol.24 (1), p.39-39, Article 39
• Main Authors: Hijazi, Mido Max, Siepmann, Timo, El-Battrawy, Ibrahim, Schröttner, Percy, Podlesek, Dino, Schackert, Gabriele, Juratli, Tareq A, Eyüpoglu, Ilker Y, Filis, Andreas
• Format: Article
• Language: English
• Subjects: Anatomy; Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacteria; Bacterial spectrum; Biopsy; Care and treatment; Coagulase; Cohort Studies; Data collection; Diagnosis; Diagnostic equipment (Medical); Discitis - complications; Discitis - diagnosis; Discitis - therapy; Disease; Disease Progression; Drug resistance; Embolism; Empyema; Empyema - complications; Endocarditis; Endocarditis, Bacterial - complications; Epidural; Germany; Gram-Negative Bacteria; Gram-Positive Bacteria; Health aspects; Hemodynamics; Hospitals; Humans; Infectious bone diseases; Infective endocarditis; Isolated spinal epidural empyema; Laboratories; Magnetic resonance imaging; Methicillin; Methicillin-Resistant Staphylococcus aureus; Microbiology; Mortality; Osteomyelitis; Pathogens; Patients; Penicillin; Penicillin G; Phenotypes; Public health; Retrospective Studies; Sepsis; Sepsis - complications; Spine; Spine (cervical); Spondylodiscitis; Staphylococcal Infections - complications; Staphylococcal Infections - diagnosis; Staphylococcal Infections - therapy; Staphylococcus aureus; Staphylococcus aureus infections; Staphylococcus infections; Surgery; Target detection; Urinary tract; Urinary tract infections
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-023-08946-x

Personalized clinical management of spondylodiscitis (SD) and isolated spinal epidural empyema (ISEE) is challenging due to limited evidence of microbiologic findings and their clinical impact during the clinical course of the disease. We aimed to characterize clinico-microbiological and imaging phenotypes of SD and ISEE to provide useful insights that could improve outcomes and potentially modify guidelines. We performed chart review and collected data on the following parameters: bacterial antibiogram-resistogram, type of primary spinal infection, location of spinal infection, source of infection, method of detection, clinical complications (sepsis, septic embolism, and endocarditis), length of hospital and intensive care unit (ICU) stay, relapse rate, and disease-related mortality in patients with proven pyogenic SD and ISEE treated surgically in a university hospital in Germany between 2002 and 2022. We included data from 187 patients (125 SD, 66.8% and 62 ISEE, 33.2%). Gram-positive bacteria (GPB) were overall more frequently detected than gram-negative bacteria (GNB) (GPB: 162, 86.6% vs. GNB: 25, 13.4%, p