gms | German Medical Science

67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Distribution of underlying causative organisms, patient age and survival in spontaneous spondylodiscitis with special focus on elderly patients

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  • Stephan Lackermair - Krankenhaus Barmherzige Brüder Regensburg, Neurochirurgische Klinik, Germany
  • Hannes Egermann - Krankenhaus Barmherzige Brüder Regensburg, Neurochirurgische Klinik, Germany
  • Adolf Müller - Krankenhaus Barmherzige Brüder Regensburg, Neurochirurgische Klinik, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocDI.10.06

doi: 10.3205/16dgnc157, urn:nbn:de:0183-16dgnc1571

Published: June 8, 2016

© 2016 Lackermair et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

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Objective: Spondylodiscitis is a more and more frequently encountered diagnosis in our clinical practice. Multimorbid and especially older patients build up a relevant portion of cases. The goal of our study was to evaluate our clinics data and to reveal specifics concerning elderly patients with spontaneous spondylodiscitis.

Method: We made a retrospective analysis of our clinics data for the years 2012 to 2014. Search was conducted on the base of ICD-10- diagnoses for spondylodiscitis. Postoperative infections were not included in this study. All cases were evaluated in terms of infectious agents (in blood culture and/or CT-guided or surgical biopsy), age and overall survival.

Results: 51 patients with spontaneous spondylodiscitis were detected during the observational interval. The most frequent pathogen was Methicillin-sensitive S. aureus (MSSA, n=21; 41,17 %). E. coli and S. epidermidis were each found in 4 patients (each 7,84 %). There was a proof of Methicillin-resistant S. aureus (MRSA), Pseudomonas aeruginosa and S. hominis each in 3 cases (each 5,88 %). Other bacteria were found in each 1 case (each 1,96 %). In 12 cases there was no growth (23,53%). One of these patients revealed to have a TBC infection after the study period (in 2015). 2/3 of patients were ≥65 ys. (n=34). All 3 patients with MRSA were >65 ys. 3 of 7 patients <50 ys. had i.v. drug abuse (43 %). In these patients rather rare infectious agents for spondylodiscitis were found (Ps. aeruginosa, S. hominis, Citrobacter). Mortality was 7,84 % (n=4). All of these patients were ≥67 ys. 3 of 4 (75 %) were ≥75 ys.

Conclusions: Our evaluation of spontaneous spondylodiscitis showed a stronger representation of older patients (>65 y). Lethal outcome exclusively concerned the older age group in this study. S. aureus was confirmed to be the most frequent pathogen as shown before. MRSA-infections might be more common in the older age group with limited significance in the small subgroup. Rare causative organisms mainly occurred in patients with i.v. drug abuse. Further evaluation through randomized multicentre-studies focusing on the different subgroups and comorbidities in larger populations and correlation with appropriate treatment options are necessary.