Premru Manica Müller, Spik Vesna Cvitković, Furlan Stanka Lotric, Zupanc Tatjana Lejko
Institute of Microbiology and Immunology, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
Scand J Infect Dis. 2010 Oct;42(10):763-6. doi: 10.3109/00365548.2010.492398.
Infectious spondylodiscitis is diagnosed with increasing frequency. It is most commonly caused by Staphylococcus aureus. The aim of the present study was to determine clinical differences between S. aureus and non-S. aureus spondylodiscitis and, by using spa typing, to determine whether certain clones of S. aureus predominate. During the y 2002-2006, 70 patients (45 male, 25 female) were diagnosed with spondylodiscitis and treated at the Department of Infectious Diseases, University Medical Centre Ljubljana. The age range was 13-95 y (mean age 63.4 y). Cultures were positive in 59 (85%) patients; S. aureus was isolated from blood and/or vertebral disc in 42 (60%) and other bacteria were isolated in 17 (25%). In patients with S. aureus spondylodiscitis, the infection was more likely to be haematogenous. These patients were more likely at risk for epidural abscess. Thirty S. aureus isolates from blood were typed with the spa typing molecular method. All of them were methicillin-susceptible. We identified 20 spa types. Seven spa types (t005, t015, t026, t091, t116, t449 and t474) were identified more than once, while 13 were sporadic. Among the sporadic spa types, 6 were newly identified in this study and introduced as new types into the spa server database. A heterogeneity of S. aureus isolates from spondylodiscitis was detected in this study. Thus no specific clone was identified that might be more likely to cause infection of the spine.
感染性脊椎椎间盘炎的诊断频率日益增加。其最常见的病因是金黄色葡萄球菌。本研究的目的是确定金黄色葡萄球菌性与非金黄色葡萄球菌性脊椎椎间盘炎的临床差异，并通过葡萄球菌蛋白A（spa）分型来确定某些金黄色葡萄球菌克隆是否占主导地位。在2002年至2006年期间，70例患者（45例男性，25例女性）被诊断为脊椎椎间盘炎，并在卢布尔雅那大学医学中心传染病科接受治疗。年龄范围为13至95岁（平均年龄63.4岁）。59例（85%）患者的培养结果呈阳性；42例（60%）患者的血液和/或椎间盘分离出金黄色葡萄球菌，17例（25%）分离出其他细菌。在金黄色葡萄球菌性脊椎椎间盘炎患者中，感染更可能是血源性的。这些患者发生硬膜外脓肿的风险更高。采用spa分型分子方法对30株血液中的金黄色葡萄球菌分离株进行分型。所有分离株均对甲氧西林敏感。我们鉴定出20种spa型。7种spa型（t005、t015、t026、t091、t116、t449和t474）被多次鉴定到，而13种为散发性。在散发性spa型中，6种是本研究中新鉴定出的，并作为新类型录入spa服务器数据库。本研究检测到脊椎椎间盘炎患者的金黄色葡萄球菌分离株具有异质性。因此，未鉴定出可能更易引起脊柱感染的特定克隆。
