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. 2024 Apr 26;13(9):2557.
doi: 10.3390/jcm13092557.

Regional Spondylodiscitis Disparities: Impact on Pathogen Spectrum and Patients

Tobias Pantel  1 , Klaus Christian Mende  1   2 , Martin Stangenberg  3   4 , Malte Mohme  1 , Theresa Mohme  1   5 , Frank Floeth  6 , Sven Oliver Eicker  1   7 , Marc Dreimann  3   8
Affiliations

Regional Spondylodiscitis Disparities: Impact on Pathogen Spectrum and Patients

Tobias Pantel et al. J Clin Med. .

Abstract

Background: Spondylodiscitis is an infectious disease affecting an intervertebral disc and the adjacent vertebral bodies and is often the complication of a distant focus of infection. This study aims to ascertain the regional and hospital-specific disparities in bacterial patterns and resistance profiles in spontaneous and iatrogenic spondylodiscitis and their implications for patient treatment. Methods: We enrolled patients from two German hospitals, specifically comparing a university hospital (UVH) with a peripheral non-university hospital (NUH). We documented patient demographics, laboratory results, and surgical interventions. Microbiological assessments, antibiotic regimens, treatment durations, and resistance profiles were recorded. Results: This study included 135 patients. Upon admission, 92.4% reported pain, with 16.2% also presenting neurological deficits. The primary microbial species identified in both the UVH and NUH cohorts were S. aureus (37.3% vs. 31.3%) and cog. neg. staphylococci (28.8% vs. 34.4%), respectively. Notably, a higher prevalence of resistant bacteria was noted in the UVH group (p < 0.001). Additionally, concomitant malignancies were significantly more prevalent in the UVH cohort. Conclusion: Significant regional variations exist in bacterial prevalence and resistance profiles. Consequently, treatment protocols need to consider these nuances and undergo regular critical evaluation. Moreover, patients with concurrent malignancies face an elevated risk of spondylodiscitis.

Keywords: antibiotic therapy; concomitant malignancy; immunosuppressive conditions; multidisciplinary therapy outcome; spinal infection.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Comparison of initial surgical treatment between UVH and NUH. Chi2 p < 0.001.
Figure 2
Figure 2
Bacterial specimen by Hospital UVH vs. NUH. Miscellaneous and tuberculosis bacteria were reported more frequently at the UVH; however, they did not reach statistical significance. Chi2 p = 0.13 (NS).
Figure 3
Figure 3
Antibiotics used by the center. The red bar indicates the antibiotic was used, one row per case.
Figure 4
Figure 4
Antibiotic resistances by center. The red bar indicates resistant species. One row per case. Cases with missing information regarding resistance were excluded from this analysis.
See this image and copyright information in PMC

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