The co-occurrence of spondylodiscitis and periprosthetic joint infections: clinical and microbiological perspectives

To assess the potential relationship between synchronous and metachronous occurrences of spondylodiscitis and subsequent periprosthetic joint infection (PJI), shedding light on the interplay between these two distinct yet interconnected conditions. The secondary aim was to investigate the time interval between the occurrences of spondylodiscitis and PJI in metachronous infections, and to identify potential similarities or differences in the causative pathogens between synchronous and metachronous infections.

A retrospective single-center study was performed. Patients diagnosed with either spondylodiscitis or PJI (based on the 2018 International Consensus Meeting criteria) were included. Demographic, clinical, laboratory and microbiology patient data were retrieved.

The incidence of metachronous infection and synchronous infection were 86.7% and 13.3% respectively. In metachronous infections, time between spondylodiscitis and PJI was 29.1 months (SD 31.1). The most common relation between spondylodiscitis and PJI were between hip PJI and lumbar spondylodiscitis. There was a statistically significant difference in the time between spondylodiscitis and PJI in the patient who had or had not arthroplasty prior to the spondylodiscitis (p = 0.02). The spondylodiscitis and PJI concomitant infection were predominant a monobacterial infection. Staphylococcus aureus was the most frequent species isolated (47.6%). The same organism was isolated in the cultures in metachronous and in the synchronous infections between spondylodiscitis and PJI in 100% of cases.

The findings of this study suggest a potential link between spondylodiscitis and PJI; however, further research is required to understand the mechanisms underlying the potential relationship between these events, as well as to develop effective strategies for prevention, diagnosis, and treatment of these infections.

Level IV, Retrospective case series.