Timely surgery and time to culture positivity: prognostic indicators in Staphylococcus-related pyogenic...

Area of Science:

• Spine surgery
• Infectious disease
• Microbiology

Background:

• Time to culture positivity (TTP) is a known indicator for bacterial load in bloodstream infections.
• Its prognostic value in pyogenic spondylodiscitis using intraoperative tissue cultures is not well-established.
• Optimal surgical timing for pyogenic spondylodiscitis requires further definition.

Purpose of the Study:

• To evaluate the prognostic significance of TTP in Staphylococcus-related pyogenic spondylodiscitis.
• To determine the optimal surgical timing for improved patient outcomes.

Main Methods:

• Retrospective cohort study of 48 patients with Staphylococcus-related pyogenic spondylodiscitis.
• Analysis of overall survival (OS) and recurrence-free survival (RFS).
• Cox regression models to identify predictors of outcomes and optimal cut-off values for TTP and surgical timing.

Main Results:

• One-year OS was 76% and RFS was 58%.
• Prolonged TTP (≥ 60 hours) was associated with significantly better OS and RFS (HR 0.18, p=0.003 for OS; HR 0.27, p=0.003 for RFS).
• Timely surgery (≤ 14 days) was also linked to improved OS and RFS (HR 0.22, p=0.019 for OS; HR 0.35, p=0.024 for RFS).

Conclusions:

• Timely surgical intervention (within 14 days) and prolonged TTP (over 60 hours) correlate with enhanced survival in Staphylococcus-related pyogenic spondylodiscitis.
• These factors can aid in risk stratification and clinical decision-making.
• Integrating TTP and surgical timing may optimize management strategies for this condition.