Infections of the spine are still a great problem

Stern, Ludmila; Serrano, C. León

doi:10.1007/s00264-012-1504-y

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…Infections of the spine are persistent global problems [ 1 ]. Historically, they were predominantly associated with tuberculosis (Pott’s disease), and this pathology remains a common cause in today’s world [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Treatment of lumbar discitis using silicon nitride spinal spacers: A case series and literature review

Rambo

2018

International Journal of Surgery Case Reports

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HighlightsSpinal infections are serious maladies affecting a growing number of patients worldwide.The diagnosis and treatment of these infections are often delayed because their symptoms mimic degenerative spinal disorders.Two cases of pyogenic lumbar discitis due to Escherichia coli and Candida albicans pathogens are presented.Resolution of discitis, and successful arthrodesis without hardware, were achieved in both cases with a silicon nitride spacer.

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Section: Introductionmentioning

confidence: 99%

Treatment of lumbar discitis using silicon nitride spinal spacers: A case series and literature review

Rambo

2018

International Journal of Surgery Case Reports

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“…Infection is often spontaneous and hematogenous in origin but can also occur after invasive spinal surgery (Lecouvet et al, 2004 ; Duarte and Vaccaro, 2013 ). There is still inadequate knowledge about all risk factors, clinical features, diagnostic methods, and appropriate treatment for adults with spondylodiscitis (Cebrian Parra et al, 2012 ; Lopez-Duran Stern and Leon Serrano, 2012 ). Known significant predisposing factors that could contribute to spinal infections include previous spine surgery, a distant infectious focus, diabetes mellitus, advanced age, intravenous drug use, HIV infection, immunosuppression, oncologic history, and renal failure (Duarte and Vaccaro, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

Pathogen Identification in Suspected Cases of Pyogenic Spondylodiscitis

Sheikh

Khosravi

Goodarzi

et al. 2017

Front. Cell. Infect. Microbiol.

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Pyogenic spinal infection continues to represent a worldwide problem. In approximately one-third of patients with pyogenic spondylodiscitis, the infectious agent is never identified. Of the cases that lead to organismal identification, bacteria are more commonly isolated from the spine rather than fungi and parasites. This study applied universal prokaryotic 16S rRNA PCR as a rapid diagnostic tool for the detection of bacterial agents in specimens from patients suspected of pyogenic spondylodiscitis. Gram and Ziehl-Neelsen staining were used as a preliminary screening measure for microbiologic evaluation of patient samples. PCR amplification targeting 16S rRNA gene was performed on DNA extracted from 57 cases including specimens from epidural abscesses, vertebral, and disc biopsies. Positive samples were directly sequenced. MRI findings demonstrated that disc destruction and inflammation were the major imaging features of suspected pyogenic spondylodiscitis cases, as 44 cases showed such features. The most common site of infection was the lumbar spine (66.7%), followed by thoracic spine (19%), the sacroiliac joint (9.5%), and lumbar-thoracic spine (4.8%) regions. A total of 21 samples amplified the 16S rRNA-PCR product. Sanger sequencing of the PCR products identified the following bacteriological agents: Mycobacterium tuberculosis (n = 9; 42.9%), Staphylococcus aureus (n = 6; 28.5%), Mycobacterium abscessus (n = 5; 23.8%), and Mycobacterium chelonae (n = 1; 4.8%). 36 samples displayed no visible 16S rRNA PCR signal, which suggested that non-bacterial infectious agents (e.g., fungi) or non-infectious processes (e.g., inflammatory, or neoplastic) may be responsible for some of these cases. The L3–L4 site (23.8%) was the most frequent site of infection. Single disc/vertebral infection were observed in 9 patients (42.85%), while 12 patients (57.15%) had 2 infected adjacent vertebrae. Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) inflammatory markers were noted in majority of the patients. In conclusion, microbiological methods and MRI findings are vital components for the proper diagnosis of pyogenic spondylodiscitis. Our findings suggest that molecular methods such as clinical application of 16S rRNA PCR and sequencing may be useful as adjunctive diagnostic tools for pyogenic spondylodiscitis. The rapid turnaround time of 16S rRNA PCR and sequencing submission and results can potentially decrease the time to diagnosis and improve the therapeutic management and outcome of these infections. Although S. aureus and M. tuberculosis were the most common causes of pyogenic spinal infections in this study, other infectious agents and non-infectious etiologies should be considered. Based on study results, we advise that antibiotic therapy should be initiated after a definitive etiological diagnosis.

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Espondilitis infecciosa: treinta años después persisten los mismos problemas. ¿Debemos cambiar el enfoque?

Pardo

García

2015

Revista Clínica Española

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Infections of the spine are still a great problem

Cited by 6 publications

References 24 publications

Treatment of lumbar discitis using silicon nitride spinal spacers: A case series and literature review

Treatment of lumbar discitis using silicon nitride spinal spacers: A case series and literature review

Pathogen Identification in Suspected Cases of Pyogenic Spondylodiscitis

Espondilitis infecciosa: treinta años después persisten los mismos problemas. ¿Debemos cambiar el enfoque?

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