Suppr超能文献

革兰氏阴性菌引起的化脓性脊柱炎的临床特征及危险因素

Clinical characteristics and risk factors of pyogenic spondylitis caused by gram-negative bacteria.

作者信息

Kang Seung-Ji, Jang Hee-Chang, Jung Sook-In, Choe Pyoeng Gyun, Park Wan Beom, Kim Chung-Jong, Song Kyoung-Ho, Kim Eu Suk, Kim Hong Bin, Oh Myoung-Don, Kim Nam Joong, Park Kyung-Hwa

机构信息

Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, South Korea.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.

出版信息

PLoS One. 2015 May 15;10(5):e0127126. doi: 10.1371/journal.pone.0127126. eCollection 2015.

Abstract

BACKGROUND

There are limited data describing the clinical characteristics of pyogenic spondylitis caused by Gram-negative bacteria (GNB). The aim of this study was to investigate the predisposing factors and clinical characteristics of pyogenic spondylitis caused by GNB compared to Gram-positive cocci (GPC).

METHODS

We performed a retrospective review of medical records from patients with culture-confirmed pyogenic spondylitis at four tertiary teaching hospitals over an 8-year period.

RESULTS

A total of 344 patients with culture-confirmed pyogenic spondylitis were evaluated. There were 62 patients (18.0%) with pyogenic spondylitis caused by GNB and the most common organism was Escherichia coli (n = 35, 10.2%), followed by Pseudomonas aeruginosa (n = 10, 2.9%). Pyogenic spondylitis caused by GNB was more frequently associated with the female gender (64.5 vs. 35.5%, P <0.01), preexisting or synchronous genitourinary tract infection (32.3 vs. 2.1%, P< 0.01), and intra-abdominal infection (12.9 vs. 0.4%, P< 0.01) compared to patients with GPC. Although pyogenic spondylitis caused by GNB presented with severe sepsis more frequently (24.2 vs. 11.3%, P = 0.01), the mortality rate (6.0 vs. 5.2%) and the proportion of patients with residual disability (6.0 vs. 9.0%), defined as grade 3 or 4 (P = 0.78) 3 months after completion of treatment, were not significantly different compared to GPC patients.

CONCLUSION

GNB should be considered as the etiologic organism when infectious spondylitis develops in a patient with preexisting or synchronous genitourinary tract and intra-abdominal infection. In addition, the mortality rate and clinical outcomes are not significantly different between pyogenic spondylitis caused by GNB and GPC.

摘要

背景

关于革兰氏阴性菌(GNB)所致化脓性脊柱炎临床特征的数据有限。本研究旨在调查与革兰氏阳性球菌(GPC)相比,GNB所致化脓性脊柱炎的易感因素和临床特征。

方法

我们对8年间4家三级教学医院确诊为化脓性脊柱炎患者的病历进行了回顾性分析。

结果

共评估了344例确诊为化脓性脊柱炎的患者。其中62例(18.0%)为GNB所致化脓性脊柱炎,最常见的病原体是大肠埃希菌(n = 35,10.2%),其次是铜绿假单胞菌(n = 10,2.9%)。与GPC所致化脓性脊柱炎患者相比,GNB所致化脓性脊柱炎更常发生于女性(64.5%对35.5%,P <0.01)、存在或并发泌尿生殖道感染(32.3%对2.1%,P< 0.01)以及腹腔内感染(12.9%对0.4%,P< 0.01)。尽管GNB所致化脓性脊柱炎更常出现严重脓毒症(24.2%对11.3%,P = 0.01),但与GPC患者相比,治疗结束3个月时的死亡率(6.0%对5.2%)和残留残疾患者比例(6.0%对9.0%,定义为3级或4级,P = 0.78)并无显著差异。

结论

对于存在或并发泌尿生殖道及腹腔内感染的患者发生感染性脊柱炎时,应考虑GNB为病原体。此外,GNB所致化脓性脊柱炎与GPC所致化脓性脊柱炎的死亡率和临床结局并无显著差异。

相似文献

1
Clinical characteristics and risk factors of pyogenic spondylitis caused by gram-negative bacteria.
PLoS One. 2015 May 15;10(5):e0127126. doi: 10.1371/journal.pone.0127126. eCollection 2015.
2
Clinical characteristics and outcomes of hematogenous vertebral osteomyelitis caused by gram-negative bacteria.
J Infect. 2014 Jul;69(1):42-50. doi: 10.1016/j.jinf.2014.02.009. Epub 2014 Feb 20.
4
Neonatal airway colonization with gram-negative bacilli: association with severity of bronchopulmonary dysplasia.
Pediatr Infect Dis J. 1997 Jan;16(1):18-23. doi: 10.1097/00006454-199701000-00005.
7
Bloodstream infections in pediatric patients with acute leukemia: Emphasis on gram-negative bacteria infections.
J Microbiol Immunol Infect. 2017 Aug;50(4):507-513. doi: 10.1016/j.jmii.2015.08.013. Epub 2015 Sep 9.
9
Risk factors and outcomes for multidrug-resistant Gram-negative bacteremia in the NICU.
Pediatrics. 2014 Feb;133(2):e322-9. doi: 10.1542/peds.2013-1248. Epub 2014 Jan 13.
10
Risk of acquiring multidrug-resistant Gram-negative bacilli from prior room occupants in the intensive care unit.
Clin Microbiol Infect. 2011 Aug;17(8):1201-8. doi: 10.1111/j.1469-0691.2010.03420.x. Epub 2010 Dec 13.

引用本文的文献

1
Epidemiology and management of infectious spondylitis in Korea: a narrative review.
Ewha Med J. 2024 Jul;47(3):e37. doi: 10.12771/emj.2024.e37. Epub 2024 Jul 31.
4
in the T11-12 Thoracic Vertebrae: A Case Report.
Infect Drug Resist. 2025 Feb 5;18:693-702. doi: 10.2147/IDR.S506265. eCollection 2025.
5
A rare case of acute obstructive suppurative pancreatic ductitis (AOSPD) which developed pyogenic spondylitis.
Clin J Gastroenterol. 2024 Oct;17(5):982-988. doi: 10.1007/s12328-024-02004-y. Epub 2024 Jun 20.
8
Brucellar, Pyogenic, and Tuberculous Spondylodiscitis at Tertiary Hospitals in Saudi Arabia: A Comparative Retrospective Cohort Study.
Open Forum Infect Dis. 2023 Aug 28;10(9):ofad453. doi: 10.1093/ofid/ofad453. eCollection 2023 Sep.
10
Pyogenic spondylitis caused by : A case report and literature review.
World J Clin Cases. 2023 May 26;11(15):3583-3591. doi: 10.12998/wjcc.v11.i15.3583.

本文引用的文献

2
Clinical characteristics and outcomes of hematogenous vertebral osteomyelitis caused by gram-negative bacteria.
J Infect. 2014 Jul;69(1):42-50. doi: 10.1016/j.jinf.2014.02.009. Epub 2014 Feb 20.
4
Changing trends in the epidemiology of pyogenic vertebral osteomyelitis: the impact of cases with no microbiologic diagnosis.
Semin Arthritis Rheum. 2011 Oct;41(2):247-55. doi: 10.1016/j.semarthrit.2011.04.002. Epub 2011 Jun 12.
5
A play in four acts: Staphylococcus aureus abscess formation.
Trends Microbiol. 2011 May;19(5):225-32. doi: 10.1016/j.tim.2011.01.007. Epub 2011 Feb 25.
6
A comparative study of pyogenic and tuberculous spondylodiscitis.
Spine (Phila Pa 1976). 2010 Oct 1;35(21):E1096-100. doi: 10.1097/BRS.0b013e3181e04dd3.
8
Pyogenic vertebral osteomyelitis: identification of microorganism and laboratory markers used to predict clinical outcome.
Eur Spine J. 2010 Apr;19(4):575-82. doi: 10.1007/s00586-009-1216-1. Epub 2009 Nov 24.
9
Population-based surveillance of infectious endocarditis in an Italian region.
Arch Intern Med. 2009 Oct 12;169(18):1720-3. doi: 10.1001/archinternmed.2009.307.
10
Genetic requirements for Staphylococcus aureus abscess formation and persistence in host tissues.
FASEB J. 2009 Oct;23(10):3393-404. doi: 10.1096/fj.09-135467. Epub 2009 Jun 12.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验