Comparison of gram-negative and gram-positive hematogenous pyogenic spondylodiscitis: clinical characteristics and outcomes of treatment

BMC Infectious Diseases

Research Article

Jou-Chen Huang¹  Chien-Yin Lee²  Yen-Yao Li³  Chin-Chang Cheng⁴  Ching-Yu Lee⁴  Tsung-Jen Huang⁵  Meng-Huang Wu⁶  Tsung-Yu Huang⁷ 

[1] Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, Taiwan;Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan;Department of Orthopedic Surgery, Chang Gung Memorial Hospital, No. 6, West Sec., Chia Pu Rd., PuTz, Chiayi, Taiwan;Department of Orthopedic Surgery, Chang Gung Memorial Hospital, No. 6, West Sec., Chia Pu Rd., PuTz, Chiayi, Taiwan;College of Medicine, Chang Gung University, Taoyuan, Taiwan;Department of Orthopedic Surgery, Chang Gung Memorial Hospital, No. 6, West Sec., Chia Pu Rd., PuTz, Chiayi, Taiwan;College of Medicine, Chang Gung University, Taoyuan, Taiwan;Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan;Department of Orthopedic Surgery, Taipei Medical University Hospital, Taipei, Taiwan;Department of Orthopedic Surgery, Taipei Medical University Hospital, Taipei, Taiwan;Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan;Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan;

关键词: Gram-negative infection;    Gram-positive infection;    Hematogenous pyogenic spondylodiscitis;   

DOI  :  10.1186/s12879-016-2071-4

 received in 2016-02-15, accepted in 2016-11-28,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundTo the best of our knowledge, no study has compared gram-negative bacillary hematogenous pyogenic spondylodiscitis (GNB-HPS) with gram-positive coccal hematogenous pyogenic spondylodiscitis (GPC-HPS) regarding their clinical characteristics and outcomes.MethodsFrom January 2003 to January 2013, 54 patients who underwent combined antibiotic and surgical therapy in the treatment of hematogenous pyogenic spondylodiscitis were included.ResultsCompared with 37 GPC-HPS patients, the 17 GNB-HPS patients were more often found to be older individuals, a history of cancer, and a previous history of symptomatic urinary tract infection. They also had a less incidence of epidural abscess formation compared with GPC-HPS patients from findings on magnetic resonance imaging (MRI). Constitutional symptoms were the primary reasons for initial physician visits in GNB-HPS patients whereas pain in the affected spinal region was the most common manifestation in GPC-HPS patients at initial visit. The clinical outcomes of GNB-HPS patients under combined surgical and antibiotic treatment were not different from those of GPC-HPS patients. In multivariate analysis, independent predicting risk factors for GNB-HPS included a malignant history and constitutional symptoms and that for GPC-HPS was epidural abscess.ConclusionsThe clinical manifestations and MRI presentations of GNB-HPS were distinguishable from those of GPC-HPS.

【 授权许可】

CC BY   
© The Author(s). 2016