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脊椎椎间盘炎的临床和微生物学特征:一项回顾性分析。

Clinical and microbiological profile of spondylodiscitis: a retrospective analysis.

作者信息

Golchoub Ghazaleh, Hosseini Ida, Alamdari Amirali, Ansari Shabboo, Javandoust Gharehbagh Farid, Taheri Mahboobeh, Alavi Darazam Ilad

机构信息

School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

BMC Musculoskelet Disord. 2025 May 26;26(1):515. doi: 10.1186/s12891-025-08748-z.

Abstract

BACKGROUND

Spondylodiscitis is a rare infectious disease with rising incidence in recent years. From 2005 till 2021 the incidence of Spondylodiscitis rose by 104%. Given its potential to cause complications and mortality, it demands greater attention. Epidemiological data and predisposing factors can vary significantly across different geographical regions, suggesting that data from Iran may differ from those in other parts of the world. This study aims to evaluate the demographic, clinical, laboratory, and imaging characteristics of spondylodiscitis patients treated at Loghman Hakim Hospital in Tehran. Additionally, it seeks to analyze the treatment outcomes and complications associated with the disease.

METHODS

We conducted a retrospective analysis of 65 adult patients diagnosed with spondylodiscitis over the past decade (2012-2022). The data collected encompassed demographic characteristics, underlying diseases, clinical presentations, laboratory and radiological findings, microbiological results, treatment approaches, and outcomes.

RESULTS

The study included 65 adult patients with a mean age of 55.12 years, showing a slight male predominance (58.5%). Spondylodiscitis was community-acquired in 49.2% of cases and hospital-acquired postoperatively in 50.8%. The lumbosacral spine was the most affected region (47.4%). Staphylococcus aureus was the most frequently isolated microorganism (28.2%), followed by Mycobacterium tuberculosis. Complications included abscess formation in 49.2% of patients and multiorgan failure in 6.2%, resulting in death. Treatment primarily involved antibiotic therapy, with surgical intervention in select cases. Poor outcomes were observed in patients with unidentified microorganisms and those with longer delays in diagnosis.

CONCLUSIONS

Spondylodiscitis is associated with significant morbidity and a high rate of complications, particularly in cases with delayed diagnosis. Early diagnosis, appropriate antimicrobial therapy, and surgical intervention when necessary are crucial for improving patient outcomes. This study highlights the need for ongoing research to optimize diagnostic pathways and develop long-term management strategies for spondylodiscitis.

摘要

背景

脊椎椎间盘炎是一种罕见的感染性疾病,近年来发病率呈上升趋势。从2005年到2021年,脊椎椎间盘炎的发病率上升了104%。鉴于其引发并发症和导致死亡的可能性,它需要更多关注。不同地理区域的流行病学数据和诱发因素可能有显著差异,这表明伊朗的数据可能与世界其他地区不同。本研究旨在评估在德黑兰的洛格曼·哈基姆医院接受治疗的脊椎椎间盘炎患者的人口统计学、临床、实验室和影像学特征。此外,它还试图分析与该疾病相关的治疗结果和并发症。

方法

我们对过去十年(2012 - 2022年)诊断为脊椎椎间盘炎的65例成年患者进行了回顾性分析。收集的数据包括人口统计学特征、基础疾病、临床表现、实验室和影像学检查结果、微生物学结果、治疗方法及结果。

结果

该研究纳入了65例成年患者,平均年龄为55.12岁,男性略占优势(58.5%)。49.2%的病例为社区获得性脊椎椎间盘炎,50.8%为医院术后获得性。腰骶椎是受影响最严重的区域(47.4%)。金黄色葡萄球菌是最常分离出的微生物(28.2%),其次是结核分枝杆菌。并发症包括49.2%的患者形成脓肿,6.2%的患者出现多器官功能衰竭并导致死亡。治疗主要包括抗生素治疗,部分病例进行手术干预。未识别出微生物的患者以及诊断延迟时间较长的患者预后较差。

结论

脊椎椎间盘炎与显著的发病率和高并发症发生率相关,尤其是在诊断延迟的情况下。早期诊断、适当的抗菌治疗以及必要时的手术干预对于改善患者预后至关重要。本研究强调需要持续开展研究以优化诊断途径并制定脊椎椎间盘炎的长期管理策略。

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