Influence of microbiological diagnosis on the clinical course of spondylodiscitis

Stangenberg, Martin; Mende, Klaus Christian; Mohme, Malte; Krätzig, Theresa; Viezens, Lennart; Both, Anna; Rohde, Holger; Dreimann, Marc

doi:10.1007/s15010-021-01642-5

Cited by 23 publications

(29 citation statements)

References 29 publications

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“…Furthermore, another study found that 60% of all cases with S. aureus detection had (or progressed to developing) an epidural, paraspinous or psoas abscess [36]. Although in our study the 2.3 increased odds were just barely not statistically significant, combined with recent literature we believe an additional risk-point should be awarded indicating higher risk of a fast, more aggressive disease progression or failure of therapy [37].…”

Section: Discussioncontrasting

confidence: 49%

The Hamburg Spondylodiscitis Assessment Score (HSAS) for Immediate Evaluation of Mortality Risk on Hospital Admission

Heuer

Strahl

Viezens

et al. 2022

JCM

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(1) Background: Patients with spondylodiscitis often present with unspecific and heterogeneous symptoms that delay diagnosis and inevitable therapeutic steps leading to increased mortality rates of up to 27%. A rapid initial triage is essential to identify patients at risk for a complicative disease course. We therefore aimed to develop a risk assessment score using fast available parameters to predict in-hospital mortality of patients admitted with spondylodiscitis. (2) Methods: A retrospective data analysis of 307 patients with spondylodiscitis recruited from 2013 to 2020 was carried out. Patients were grouped according to all-cause mortality. Via logistic regression, individual patient and clinical characteristics predictive of mortality were identified. A weighted sum score to estimate a patient’s risk of mortality was developed and validated in a randomly selected subgroup of spondylodiscitis patients. (3) Results: 14% of patients with spondylodiscitis died during their in-hospital stay at a tertiary center for spinal surgery. Univariate and logistic regression analyses of parameters recorded at hospital admission showed that age older than 72.5 years, rheumatoid arthritis, creatinine > 1.29 mg/dL and CRP > 140.5 mg/L increased the risk of mortality 3.9-fold, 9.4-fold, 4.3-fold and 4.1-fold, respectively. S. aureus detection increased the risk of mortality by 2.3-fold. (4) Conclusions: The novel Hamburg Spondylodiscitis Assessment Score (HSAS) shows a good fit identifying patients at low-, moderate-, high- and very high risk for in hospital mortality on admission (AUC: 0.795; p < 0.001). The implementation of the HSAS into clinical practice could ease identification of high-risk patients using readily available parameters alone, improving the patient’s safety and outcome.

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Section: Discussioncontrasting

confidence: 49%

The Hamburg Spondylodiscitis Assessment Score (HSAS) for Immediate Evaluation of Mortality Risk on Hospital Admission

Heuer

Strahl

Viezens

et al. 2022

JCM

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“…Spondylodiscitis is an infection of the vertebral body and/or the intervertebral disc space. and is mainly caused by Staphylococcus aureus and Escherichia coli [ 73 ]; while infections with C. acnes are rare, they occur. In 2010, Uckay et al reported 29 patients with spondylodiscitis caused by C. acnes who presented with back pain [ 74 ].…”

Section: Evidence For C Acnes Biofilms In Vivomentioning

confidence: 99%

The role of biofilm formation in the pathogenesis and antimicrobial susceptibility of Cutibacterium acnes

Coenye

Spittaels

Achermann

2022

Biofilm

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Cutibacterium acnes (previously known as Propionibacterium acnes ) is frequently found on lipid-rich parts of the human skin. While C. acnes is most known for its role in the development and progression of the skin disease acne, it is also involved in many other types of infections, often involving implanted medical devices. C. acnes readily forms biofilms in vitro and there is growing evidence that biofilm formation by this Gram-positive, facultative anaerobic micro-organism plays an important role in vivo and is also involved in treatment failure. In this brief review we present an overview on what is known about C. acnes biofilms (including their role in pathogenesis and reduced susceptibility to antibiotics), discuss model systems that can be used to study these biofilms in vitro and in vivo and give an overview of interspecies interactions occurring in polymicrobial communities containing C. acnes .

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“…Similar prevalence was observed by Stangenberg in 211 patients. 31 Pola et al 29 found that 53 patients had multifocal involvement (26%). Of note, the prevalence of comorbidities in this study was almost 70%.…”

Section: Discussionmentioning

confidence: 99%

Primary spinal infections in patients with solid organ transplant: a systematic literature review and illustrative case

Hatter¹,

Beyer²,

Camino-Willhuber³

et al. 2022

Journal of Neurosurgery: Case Lessons

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BACKGROUND Primary spinal infections (PSIs) are a group of uncommon but serious infectious diseases considered more prevalent and aggressive among patients with chronic immunocompromised states. Association of PSI and solid organ transplant has not been systematically analyzed. The authors performed a systematic review analyzing clinical presentation and mortality of patients with PSI in the setting of solid organ transplant. OBSERVATIONS PSIs in patients with immunosuppressive therapy, such as those with solid organ transplant, may behave differently in terms of epidemiology, clinical presentation, and outcomes compared with nonimmunosuppressed patients. Overall PSI in solid organ transplant patients is associated with a high rate of neurological compromise, postoperative complications, and mortality. LESSONS Accurate diagnosis and appropriate treatment of PSI require a multidisciplinary effort. Localized pain is the most frequently reported symptom associated with PSI. As opposed to PSI in patients without transplant, inflammatory and infectious markers such as white blood cells and C-reactive protein are often not elevated. Furthermore, the causative microorganism profile varies significantly when compared to pyogenic spinal infection in patients without transplant. Aspergillus species was responsible for spondylodiscitis in transplant patients in more than 50% of cases, and the incidence of Aspergillus infection is projected to rise in the coming years.

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Influence of microbiological diagnosis on the clinical course of spondylodiscitis

Cited by 23 publications

References 29 publications

The Hamburg Spondylodiscitis Assessment Score (HSAS) for Immediate Evaluation of Mortality Risk on Hospital Admission

The Hamburg Spondylodiscitis Assessment Score (HSAS) for Immediate Evaluation of Mortality Risk on Hospital Admission

The role of biofilm formation in the pathogenesis and antimicrobial susceptibility of Cutibacterium acnes

Primary spinal infections in patients with solid organ transplant: a systematic literature review and illustrative case

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