Pantel Tobias, Mende Klaus Christian, Stangenberg Martin, Mohme Malte, Mohme Theresa, Floeth Frank, Eicker Sven Oliver, Dreimann Marc
Department of Neurosurgery, Hamburg University Medical Center, Martinistrasse 52, 20246 Hamburg, Germany.
Department of Neurosurgery, Friedrich-Ebert-Krankenhaus, Friesenstr. 11, 24534 Neumünster, Germany.
J Clin Med. 2024 Apr 26;13(9):2557. doi: 10.3390/jcm13092557.
: 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. 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. 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 (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 ( < 0.001). Additionally, concomitant malignancies were significantly more prevalent in the UVH cohort. 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.
脊椎椎间盘炎是一种影响椎间盘及相邻椎体的感染性疾病，通常是远处感染病灶的并发症。本研究旨在确定自发性和医源性脊椎椎间盘炎细菌模式和耐药谱的地区及医院特异性差异及其对患者治疗的影响。我们招募了来自两家德国医院的患者，具体比较了一家大学医院（UVH）和一家外围非大学医院（NUH）。我们记录了患者的人口统计学资料、实验室检查结果和手术干预情况。记录了微生物学评估、抗生素治疗方案、治疗持续时间和耐药谱。本研究纳入了135例患者。入院时，92.4%的患者报告有疼痛，16.2%的患者还存在神经功能缺损。UVH队列和NUH队列中鉴定出的主要微生物种类分别为（37.3%对31.3%）和凝固酶阴性葡萄球菌（28.8%对34.4%）。值得注意的是，UVH组中耐药菌的患病率更高（<0.001）。此外，UVH队列中合并恶性肿瘤的情况明显更为普遍。细菌患病率和耐药谱存在显著的地区差异。因此，治疗方案需要考虑这些细微差别并定期进行严格评估。此外，合并恶性肿瘤的患者发生脊椎椎间盘炎的风险更高。
