Etiology of infectious spondylodiscitis: is there an associaton with successful treatment?

Introduction Infectious spondylodiscitis is rising in incidence and and is often a late diagnosis and identification of the causative agent. The objective was to evaluate the treatment outcomes of patients with infectious spondylodiscitis depending on the positive/negative results of intraoperative microbiological culture. Material and methods Treatment outcomes of 52 patients with infectious spondylodiscitis were retrospectively analyzed with no culture growth in the biological samples (group I, n = 22) and with identified pathogen (group II, n = 30). The diagnosis was verified using MRI imaging, intraoperative microbiological culture test, the clinical picture and blood inflammation markers (ESR and CRP). Poor outcomes were associated with death and/or recurrent spondylodiscitis. Results Positive culture growth was detected in 57.7 % with staphylococci predominated in 57.2 % and Staphylococcus aureus detected in 42.9 %. Patients of group I were twice as likely to take antibiotics at the preadmission stage (p = 0.0049), had a 20 % longer delay in diagnosis (p = 0.7286), and had lower CRP and ESR levels than those in Group II (p > 0.05). Adverse events included one fatal case in each of the groups; recurrent infections occurred in 13.3 % of cases of group II (p = 0.3814) with three quarters of cases caused by Pseudomonas aeruginosa. Discussion Poor prognostic factors in infectious spondylodiscitis include negative microbiological results, neurological impairment and concomitant endocarditis (p ≤ 0.05). S. aureus associated spondylodiscitis is accompanied by increased mortality and morbidity. Patients with spondylodiscitis with a negative microbiological test result compared with patients with a culture-positive infection, had a better treatment outcome with minimum recurrent rate (p > 0.05). Conclusion Spondylodiscites with a negative microbiological result compared with a culture-positive infection had a better treatment outcome with a minimum of relapses (p > 0.05).