脊椎椎间盘炎与人工关节周围感染的并发：临床与微生物学视角
The co-occurrence of spondylodiscitis and periprosthetic joint infections: clinical and microbiological perspectives.
作者信息
Dasci Mustafa Fatih, Núñez Jorge H, Köse Özkan, Sandiford N Amir, Caliskan Berfin Selin, Luo Tianyi David, Gehrke Thorsten, Citak Mustafa
机构信息
Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey.
Helios Endo-Klinik Hamburg, Hamburg, Germany.
出版信息
Int Orthop. 2025 Jul;49(7):1599-1606. doi: 10.1007/s00264-025-06556-7. Epub 2025 May 14.
PURPOSE
To assess the potential relationship between synchronous and metachronous occurrences of spondylodiscitis and subsequent periprosthetic joint infection (PJI), shedding light on the interplay between these two distinct yet interconnected conditions. The secondary aim was to investigate the time interval between the occurrences of spondylodiscitis and PJI in metachronous infections, and to identify potential similarities or differences in the causative pathogens between synchronous and metachronous infections.
METHODS
A retrospective single-center study was performed. Patients diagnosed with either spondylodiscitis or PJI (based on the 2018 International Consensus Meeting criteria) were included. Demographic, clinical, laboratory and microbiology patient data were retrieved.
RESULTS
The incidence of metachronous infection and synchronous infection were 86.7% and 13.3% respectively. In metachronous infections, time between spondylodiscitis and PJI was 29.1 months (SD 31.1). The most common relation between spondylodiscitis and PJI were between hip PJI and lumbar spondylodiscitis. There was a statistically significant difference in the time between spondylodiscitis and PJI in the patient who had or had not arthroplasty prior to the spondylodiscitis (p = 0.02). The spondylodiscitis and PJI concomitant infection were predominant a monobacterial infection. Staphylococcus aureus was the most frequent species isolated (47.6%). The same organism was isolated in the cultures in metachronous and in the synchronous infections between spondylodiscitis and PJI in 100% of cases.
CONCLUSION
The findings of this study suggest a potential link between spondylodiscitis and PJI; however, further research is required to understand the mechanisms underlying the potential relationship between these events, as well as to develop effective strategies for prevention, diagnosis, and treatment of these infections.
LEVEL OF EVIDENCE
Level IV, Retrospective case series.
目的
评估脊椎椎间盘炎的同步和异时发生与随后的人工关节周围感染（PJI）之间的潜在关系，以阐明这两种不同但相互关联的病症之间的相互作用。次要目的是研究异时感染中脊椎椎间盘炎和PJI发生之间的时间间隔，并确定同步和异时感染之间致病病原体的潜在异同。
方法
进行了一项回顾性单中心研究。纳入诊断为脊椎椎间盘炎或PJI（基于2018年国际共识会议标准）的患者。检索了患者的人口统计学、临床、实验室和微生物学数据。
结果
异时感染和同步感染的发生率分别为86.7%和13.3%。在异时感染中，脊椎椎间盘炎和PJI之间的时间间隔为29.1个月（标准差31.1）。脊椎椎间盘炎和PJI之间最常见的关系是髋关节PJI与腰椎脊椎椎间盘炎之间的关系。在脊椎椎间盘炎之前有或没有进行关节置换术的患者中，脊椎椎间盘炎和PJI之间的时间存在统计学显著差异（p = 0.02）。脊椎椎间盘炎和PJI合并感染主要是单一细菌感染。金黄色葡萄球菌是最常分离出的菌种（47.6%）。在100%的病例中，异时感染以及脊椎椎间盘炎和PJI之间的同步感染的培养物中分离出相同的病原体。
结论
本研究结果表明脊椎椎间盘炎和PJI之间存在潜在联系；然而，需要进一步研究以了解这些事件之间潜在关系的基础机制，以及制定预防、诊断和治疗这些感染的有效策略。
证据水平
IV级，回顾性病例系列。
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