[Spondylodiscitis: clinical experience in a Chilean general hospital]

Rev Chilena Infectol. 2016 Jun;33(3):322-30. doi: 10.4067/S0716-10182016000300013.
[Article in Spanish]

Abstract

Background: Spondylodiscitis (SD) involves long periods of hospitalization, diagnostic latency and risk of long-term complications. No updated series are available in Chile and a change in demographic features and etiology is suspected.

Aim: To characterize a group of patients with SD.

Patients and methods: Clinical series including patients over an 8 year period.

Results: We identified 37 patients; 37.8% women and 62.2% men (mean age 66.8 years); 64.9% were elderly; 35.1% had diabetes and 21.6% urological comorbidity. Main symptoms were pain and fever. Erythrocyte sedimentation rate was elevated in 89.2%, and 86.5% patients had MRI, which was always confirmatory. Lumbar spine was the most common site of infection (43.2%). Etiology was identified in 28/37 patients: 71.4% yielded grampositive cocci (Staphylococcus aureus predominantly), Mycobacterium tuberculosis was identified in only 10.7%. Staphylococcus aureus was associated to medical comorbidities (p < 0,05) and gramnegative bacilli to hepatobiliar or intestinal symptoms (p < 0,05). Culture obtained by a surgical procedure had the highest yield. The average duration of antibiotic therapy was 63.8 days (IQR 53-72). Treatment-related side effects were detected in 18.9% of patients. The average hospital stay was 38.9 days. No deaths occurred during hospitalization. Motor sequelae were present in 18.9% of this series.

Discussion: Most patients with SD were older adults. Staphylococcus aureus was predominant and M. tuberculosis was uncommon. Antibiotic side effects were relevant as well as the neurological complications.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chile / epidemiology
  • Comorbidity
  • Discitis / epidemiology*
  • Discitis / microbiology*
  • Discitis / therapy
  • Female
  • Gram-Negative Bacteria / isolation & purification
  • Gram-Positive Bacteria / isolation & purification
  • Hospitals, General / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Osteomyelitis / epidemiology
  • Osteomyelitis / microbiology
  • Retrospective Studies
  • Risk Factors
  • Sex Distribution
  • Spinal Diseases / epidemiology
  • Spinal Diseases / microbiology
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / isolation & purification
  • Treatment Outcome
  • Young Adult