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Clinical characteristics and risk factors of pyogenic spondylitis caused by gram-negative bacteria

Seung-Ji Kang1, Hee-Chang Jang1, Sook-In Jung1

  • 1Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, South Korea.

Plos One
|May 16, 2015
PubMed
Abstract

Insights

Gram-negative bacteria (GNB) cause pyogenic spondylitis more often in women with genitourinary or abdominal infections. Outcomes and mortality are similar to Gram-positive cocci (GPC) infections.

Area of Science:

  • Infectious Diseases
  • Bacteriology
  • Clinical Medicine

Background:

  • Limited data exists on clinical characteristics of pyogenic spondylitis caused by Gram-negative bacteria (GNB).
  • Need to compare predisposing factors and clinical features of GNB vs. Gram-positive cocci (GPC) pyogenic spondylitis.

Purpose of the Study:

  • Investigate predisposing factors for pyogenic spondylitis caused by GNB.
  • Characterize clinical presentation and outcomes of GNB pyogenic spondylitis compared to GPC.

Main Methods:

  • Retrospective review of medical records.
  • Analysis of culture-confirmed pyogenic spondylitis cases over 8 years.
  • Comparison of GNB and GPC etiologies.

Main Results:

  • GNB (18.0%) more common than GPC, with Escherichia coli being the most frequent organism.
  • GNB associated with female gender, genitourinary, and intra-abdominal infections (P<0.01).
  • GNB presented with severe sepsis more frequently (24.2% vs. 11.3%, P=0.01), but similar mortality and disability rates.

Conclusions:

  • Consider GNB in infectious spondylitis with genitourinary/intra-abdominal infections.
  • Mortality and clinical outcomes do not significantly differ between GNB and GPC pyogenic spondylitis.

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