Núñez-Pereira Susana, Benavent Eva, Ulldemolins Marta, Sobrino-Díaz Beatriz, Iribarren José A, Escudero-Sánchez Rosa, Del Toro María Dolores, Nodar Andrés, Sorli Luisa, Bahamonde Alberto, Vilchez Helem H, Gasch Oriol, Muñez Elena, Rodríguez-Montserrat David, García-País María José, Haddad Sleiman, Sellarès-Nadal Julia, Murillo Oscar, Rodríguez-Pardo Dolors
Spine Unit, Orthopaedic Surgery Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain.
Infectious Diseases Department, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
Antibiotics (Basel). 2023 Mar 4;12(3):518. doi: 10.3390/antibiotics12030518.
Infection after spinal instrumentation (IASI) by spp. is being more frequently reported. The aim of this study was to analyse the incidence, risk factors, clinical characteristics, and outcome of a spp. IASI (CG) compared with non- IASI (NCG) infections, with an additional focus on the role of rifampin in the treatment. All patients from a multicentre, retrospective, observational study with a confirmed IASI between January 2010 and December 2016 were divided into two groups: (CG and NCG) IASI. Baseline, medical, surgical, infection treatment, and follow-up data were compared for both groups. In total, 411 patients were included: 27 CG and 384 NCG. The CG patients were significantly younger. They had a longer median time to diagnosis (23 vs. 13 days) ( = 0.025), although 55.6% debuted within the first month after surgery. patients were more likely to have the implant removed (29.6% vs. 12.8%; = 0.014) and received shorter antibiotic regimens ( = 0.014). In 33% of cases, rifampin was added to the baseline therapy. None of the 27 infections resulted in treatment failure during follow-up regardless of rifampin use. spp. is associated with a younger age and may cause both early and late IASIs. In our experience, the use of rifampin to improve the outcome in the treatment of a spp. IASI is not relevant since, in our series, none of the cases had therapeutic failure regardless of the use of rifampin.
由 菌引起的脊柱内固定术后感染（IASI）的报道越来越多。本研究的目的是分析 菌引起的 IASI（CG）与非 IASI（NCG）感染的发生率、危险因素、临床特征及转归，特别关注利福平在治疗中的作用。对 2010 年 1 月至 2016 年 12 月期间多中心回顾性观察研究中确诊为 IASI 的所有患者分为两组：（CG 和 NCG）IASI。比较两组的基线、医疗、手术、感染治疗及随访数据。共纳入 411 例患者：27 例 CG 和 384 例 NCG。CG 组患者明显更年轻。他们的中位诊断时间更长（23 天对 13 天）（P = 0.025），尽管 55.6%在术后第一个月内发病。CG 组患者更有可能取出植入物（29.6%对 12.8%；P = 0.014）且接受的抗生素治疗疗程更短（P = 0.014）。在 33%的 CG 病例中，在基线治疗中加用了利福平。27 例感染在随访期间均未出现治疗失败，无论是否使用利福平。 菌与年轻患者相关，可能导致早期和晚期 IASI。根据我们的经验，使用利福平改善 菌引起的 IASI 的治疗转归并无关联，因为在我们的系列研究中，无论是否使用利福平，均无病例出现治疗失败。
