The incidence, pathogen spectrum, and resistance profile of pyogenic spondylodiscitis: A nationwide retrospective evaluation of G-DRG data

BACKGROUND: Pyogenic spondylodiscitis is a type of infection of the spine whose incidence is rising in an aging, multimorbid population. The goal of this study is to analyze nationwide trends in Germany regarding the epidemiology, pathogen spectrum, and antimicrobial resistance profile of this disease over the period 2005-2023. METHODS: All hospital discharges were retrospectively analyzed with nationwide data on German Diagnosis Related Groups (G-DRG). Hospitalizations with a primary ICD-10-GM diagnosis of spinal osteomyelitis, a pyogenic intervertebral disc infection, or discitis, not otherwise specified (M46.2*, M46.3*, M46.4*) were included in the analysis. The age-adjusted incidence was calculated using population data from the Federal Statistical Office of Germany. Pathogen determinations and resistance phenotypes were ascertained from supplementary pathogen codes. RESULTS: were identified more frequently. There was an overall downward trend in the rate of resistant pathogens in the final six years of the study period, from 14.1% in 2017 to 6.9% in 2023. CONCLUSION: In Germany, pyogenic spondyodiscitis mainly affects older patients, and the associated in-hospital mortality is rising. Changes in the pathogen spectrum and in resistance patterns indicate the need for corresponding adjustments to empirical treatment regimens.