Related Experiment Video
Updated: Apr 9, 2026
Microbiota Analysis Using Two-step PCR and Next-generation 16S rRNA Gene Sequencing
Published on: October 15, 2019
A Comparison of Demographic and Microorganism Differences Between De Novo and Postoperative Infections
Rajkishen Narayanan1, Michael Carter, Gregory Toci
1Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
Study Design:
Retrospective cohort.
Objectives:
To compare demographic and microorganism culture data between primary and postoperative infections.
Background:
Current literature suggests that both de novo and postoperative infection rates are increasing. At present, there is a paucity of research directly comparing de novo and postoperative spinal infections.
Methods:
Patients aged 18 years or older who underwent an irrigation and debridement (I&D) for de novo spine infections and infections following elective spine surgeries from 2017 to 2023 were compared. All patients were retrospectively reviewed for demographic information, comorbidities, and social history. Tissue microbiology of both cohorts was compared by broad classes (eg, gram-positive vs gram-negative, aerobic vs anaerobic, monomicrobial vs polymicrobial) and individual microbes (eg, Staphylococcus aureus, E. Coli, Pseudomonas, etc). Statistical analysis was performed, and P-value <0.05 was considered statistically significant.
Results:
One hundred fifty-three patients underwent an I&D in the setting of a de novo spine infection, while 239 patients underwent an I&D in the setting of a postoperative infection. Patients who developed de novo infections were on average younger (P = 0.002) with lower BMIs (P < 0.001) and were more likely to be current smokers (P = 0.005). These patients also had higher rates of hepatitis C (P < 0.001), CKD (P = 0.009), and prior IV drug use (P < 0.001). De novo infections had higher rates of gram-positive (P = 0.004), monomicrobial (P = 0.013), and aerobic (P = 0.026) infections than postoperative infections. Staphylococcusaureus infection rates were statistically similar between groups (P = 0.138), while Streptococcus was more common in the postoperative infection cohort (P = 0.002). Pseudomonas, proteus, and Corynebacterium were identified significantly more often in the postoperative infection cohort.
Conclusions:
Patients developing de novo and postoperative spine infections exhibit notable demographic and microorganism differences. Adequate treatment of patients with spinal infections, therefore, requires an awareness of both medical and social factors most prevalent within these two populations.
Insights
Patients with de novo spine infections are younger, more likely to smoke, and have higher rates of certain comorbidities compared to those with postoperative infections. Microorganism profiles also differ, necessitating tailored treatment approaches for spinal infections.
Area of Science:
- Orthopedics
- Infectious Diseases
- Epidemiology
Background:
- Increasing rates of both de novo and postoperative spinal infections are noted in current literature.
- A significant gap exists in research directly comparing the characteristics of de novo versus postoperative spinal infections.
Purpose of the Study:
- To compare demographic and microorganism culture data between primary (de novo) and postoperative spinal infections.
- To identify distinct patient profiles and microbial patterns associated with each type of spinal infection.
Main Methods:
- A retrospective cohort study comparing patients aged 18+ who underwent irrigation and debridement (I&D) for de novo or postoperative spinal infections between 2017 and 2023.
- Data collected included demographics, comorbidities, social history, and tissue microbiology.
- Statistical analysis was performed to compare the two cohorts, with P < 0.05 considered significant.
Main Results:
- Patients with de novo infections were younger, had lower BMIs, and were more likely to be smokers, have hepatitis C, CKD, or a history of IV drug use.
- De novo infections showed higher rates of gram-positive, monomicrobial, and aerobic organisms.
- Staphylococcus aureus was similar between groups, while Streptococcus, Pseudomonas, Proteus, and Corynebacterium were more prevalent in the postoperative cohort.
Conclusions:
- Significant demographic and microbiological differences exist between de novo and postoperative spinal infections.
- Effective management of spinal infections requires consideration of unique medical and social factors pertinent to each patient group.
More Related Videos
Related Concept Videos
01:30Development of Human Microbiota
01:28Development of the Oral Microbiota
01:22Introduction to the Human Microbiota
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:30Methods to Assess Microbial Populations
01:28Microbiota of the Urogenital Tract