Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-cho, Yonago, Tottori, 683-8504, Japan.
Int Orthop. 2012 Jun;36(6):1229-34. doi: 10.1007/s00264-011-1440-2. Epub 2011 Dec 22.
Japan has one of the most rapidly increasing numbers of elderly individuals; therefore, future trends in spinal infections in the elderly in other countries may be predicted by studying such characteristics in Japan. The purposes of this study were to identify whether the incidence of spinal infection in individuals more than 80 years old is increasing and to define its clinical characteristics.
We retrospectively reviewed the medical records of 98 patients treated in our hospital for spinal infection between 1999 and 2008. Patients were divided into two groups: those admitted to our hospital during the initial five year period, and those admitted during the latter five year period. We evaluated changes in the percentage of individuals over the age of 80 years. To define the clinical characteristics of spinal infection, patients were also divided into another set of two groups: those over 80 years and those around the age of 80 years.
The percentage of patients over 80 years with spinal infection was significantly increasing. There was no significant difference in the gender distribution, prevalence of immunocompromised hosts, common involved levels, or mortality rate between the two age groups. The pathogenic organism was isolated in 78.6%, and of these, the rate of methicillin-resistant Staphylococcus aureus or epidermidis was 2.46 times higher in the elderly group than in the younger group.
The number of patients over 80 years with spinal infection is expected to rapidly increase in aging societies. This advanced age group is more susceptible to infection with drug-resistant organisms, which makes infection management more difficult.
日本是人口老龄化增长最快的国家之一；因此，通过研究日本老年人脊柱感染的特点，或许可以预测其他国家未来老年人脊柱感染的趋势。本研究旨在确定 80 岁以上人群脊柱感染的发病率是否在增加，并确定其临床特征。
我们回顾性分析了 1999 年至 2008 年在我院治疗的 98 例脊柱感染患者的病历。患者分为两组：前 5 年入院组和后 5 年入院组。我们评估了 80 岁以上人群比例的变化。为了明确脊柱感染的临床特征，我们还将患者分为另一组：80 岁以上组和 80 岁左右组。
80 岁以上脊柱感染患者的比例明显增加。两组在性别分布、免疫功能低下宿主的发生率、常见受累水平或死亡率方面无显著差异。78.6%的患者分离出病原菌，其中老年组耐甲氧西林金黄色葡萄球菌或表皮葡萄球菌的检出率是年轻组的 2.46 倍。
在老龄化社会中，80 岁以上脊柱感染患者的数量预计将迅速增加。这一年龄组人群更易感染耐药菌，使感染管理更加困难。
