Clinical features, outcomes, and survival factor in patients with vertebral osteomyelitis infected by methicillin-resistant staphylococci

Shoji, Hirokazu; Urakawa, Takaaki; Watanabe, Kei; Hirano, Tôru; Katsumi, Keiichi; Ohashi, Masayuki; Sato, Tsuyoshi; Yamazaki, A.; Yajiri, Yoichi; Kikuchi, Ren; Hosaka, Noboru; Sawakami, Kimihiko; Miura, Kazuto; Nakamura, Ichiro; Fujikawa, Ryuta; Wakasugi, Masashi; Endo, Naoto

doi:10.1016/j.jos.2016.01.009

Cited by 8 publications

(3 citation statements)

References 17 publications

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“…Aeruginosa. О значимости St. Aureus, его резистентной формы, а также полимикробных поражений в качестве факторов риска неблагоприятных исходов остеомиелита позвоночника сообщается в ряде публикаций [12,14].…”

Section: Discussionunclassified

“…Не во всех исследованиях сахарный диабет признан значимым фактором риска, влияющим на смертность и общее количество неудовлетворительных результатов лечения [9], но в большинстве работ этот факт является неоспоримым [12,13]. Имеется существенное влияние возбудителя на исход заболевания, в частности, метициллин-резистентный золотистый стафилококк (MRSA) увеличивает количество летальных исходов, поэтому своевременное хирургическое вмешательство является фактором, способствующим выживаемости [14].…”

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Hospital mortality in hematogenous vertebral osteomyelitis

et al. 2021

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Objective. To analyze lethal outcomes in patients with hematogenous vertebral osteomyelitis.Material and Methods. Study design: retrospective analysis of medical records. A total of 209 medical records of inpatients who underwent treatment for hematogenous vertebral osteomyelitis in 2006–2017 were analyzed. Out of them 68 patients (32.5 %) were treated conservatively, and 141 (67.5 %) – surgically. The risk factors for lethal outcomes were studied for various methods of treatment, and a statistical analysis was performed.Results. Hospital mortality (n = 9) was 4.3 %. In patients who died in hospital, average time for diagnosis making was 4 times less (p = 0.092). The main factors affecting mortality were diabetes mellitus (p = 0.033), type C lesion according to the Pola classification (p = 0.014) and age over 70 years (p = 0.006). To assess the relationship between hospital mortality and the revealed differences between the groups, a regression analysis was performed, which showed that factors associated with mortality were Pola type C.4 lesions (OR 9.73; 95 % CI 1.75–54.20), diabetes mellitus (OR 5.86; 95 % CI 1.14–30.15) and age over 70 years (OR 12.58; 95 % CI 2.50–63.34). The combination of these factors increased the likelihood of hospital mortality (p = 0.001). Sensitivity (77.8 %) and specificity (84.2 %) were calculated using the ROC curve. In the group with mortality, the comorbidity index (CCI) was significantly higher (≥4) than in the group without mortality (p = 0.002). With a CCI of 4 or more, the probability of hospital death increases significantly (OR 10.23; 95 % CI 2.06–50.82), p = 0.005. Long-term mortality was 4.3 % (n = 9), in 77.8 % of cases the cause was acute cardiovascular pathology, and no recurrence of vertebral osteomyelitis was detected.Conclusion. Hospital mortality was 4.3 %, and there was no mortality among patients treated conservatively. The main risk factors were diabetes mellitus, type C lesion according to Pola and age over 70 years. There was a significant mutual burdening of these factors (p = 0.001). With CCI ≥4, the probability of death is higher (p = 0.005).

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Hospital mortality in hematogenous vertebral osteomyelitis

et al. 2021

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“…Titanium mesh cages(TMCs) lled with autologous bone grafts have been widely applied and could achieve high bony fusion rates. However, the surgical planning and results could be affected by the subsidence, stress shielding, and radio-opacity [20]. Thus, our research aimed to nd a new bone graft that could provide biomechanical support and achieve bony fusion to reduce the incidence of complications.…”

Section: Discussionmentioning

confidence: 99%

Clinical Results Of A Lamina With Spinous Process And An Iliac Graft As Bone Grafts In The Surgical Treatment Of Single-Segment Lumbar Pyogenic Discitis: A Retrospective Cohort Study

Zhong

Liang

Wang

et al. 2020

Preprint

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Background: A retrospective study investigated and compared the results of a lamina withspinous process (LSP) and an iliac graft (IG) as bone grafts in single-segment lumbar pyogenic discitis (LPD) through one-stage-posterior-only approach with radical debridement and internal instrumentation.Methods: Data from 37 patients were reviewed. A LSP was placed in 17 patients (group A), and an IG was implemented in 20 patients (group B). The surgery time, surgery hemorrhage, hospital stay, drainage, and follow-up (FU) were reviewed. The visual analogue scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, segmental angle, intervertebral height and bony fusion time were compared preoperatively and at the final FU.Results: All patients were followed-up for a mean of 27.94±2.35 months in group A and 30.29±1.89 months in group B, without a difference. The mean age was younger in group A than in group B (P<0.05). The surgery time, surgery hemorrhage, and hospitalization cost were lower in group A than in group B (P<0.05), except for the hospital stay and drainage time. Fever occurred in 10 patients in group A and 12 patients in group B. The ESR, CRP level, and VAS and ODI scores were significantly decreased, and there were no significant differences between the groups at the final FU. The distribution of bacterial agents in blood culture was 1 case of Aerobacter cloacae, 2 of Staphylococcus aureus, 2 of Escherichia coli, and 1 of Streptococcus viridis in group A and 1 of S. aureus，1 of Staphylococcus warneri and 2 of Klebsiella pneumoniae in group B. Pyogenic infection was observed in the pathological findings of all patients. No significant difference was found in the mean segmental angle or mean intervertebral height preoperation and at the final FU between the groups.Conclusion: The use of LSP as a new bone graft is reliable, safe, and effective for surgical management for the LPD while surgery is proposed as a good management strategy for LPD in carefully selected patients.

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Interface Polarization Strengthened Microwave Catalysis of MoS₂/FeS/Rhein for the Therapy of Bacteria‐Infected Osteomyelitis

Jin

Liu

Zheng

et al. 2022

Adv Funct Materials

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Staphylococcus aureus (S. aureus)‐induced osteomyelitis is fatal to patients, even leading to death without timely debridement processing, which is difficult to be treated by antibiotics or phototherapy due to deep infections. Herein, a microwave (MW) assisted bacteria‐killing strategy for treating S. aureus‐induced osteomyelitis by using MW‐responsive molybdenum disulfide (MoS2)/ferrous sulfide (FeS) heterojunction with anti‐inflammatory herb of rhein (Rhe) is reported. Under medical MW irradiation, MoS2/FeS/Rhe effectively eradicates S. aureus‐infected rat tibial osteomyelitis. The robust therapeutic effects of MoS2/FeS/Rhe are ascribed to the anti‐inflammatory effect of Rhe, the enhanced MW thermal and dynamic effects of MoS2/FeS. MoS2/FeS is composed of S‐Mo‐S‐Fe‐S stacked layers sandwiched in between by weak Van Der Waals interactions, which means that ions or molecules can be retained in the space between the layers. Under MW irradiation, dipoles or ions are aligned in an oscillating electric field, which cause dipolar polarization and ionic conduction, leading to molecular friction and dielectric loss to generate MW heat. In addition, the dipole orientation polarization caused by the interfacial polarization of MoS2/FeS is the main factor for microwave catalysis. This kind of MW responsive nanocomposite comprising inorganics and herbs may solve the challenge of how to effectively treat deep tissue infections.

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Clinical features, outcomes, and survival factor in patients with vertebral osteomyelitis infected by methicillin-resistant staphylococci

Cited by 8 publications

References 17 publications

Hospital mortality in hematogenous vertebral osteomyelitis

Hospital mortality in hematogenous vertebral osteomyelitis

Clinical Results Of A Lamina With Spinous Process And An Iliac Graft As Bone Grafts In The Surgical Treatment Of Single-Segment Lumbar Pyogenic Discitis: A Retrospective Cohort Study

Interface Polarization Strengthened Microwave Catalysis of MoS₂/FeS/Rhein for the Therapy of Bacteria‐Infected Osteomyelitis

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Clinical features, outcomes, and survival factor in patients with vertebral osteomyelitis infected by methicillin-resistant staphylococci

Cited by 8 publications

References 17 publications

Hospital mortality in hematogenous vertebral osteomyelitis

Hospital mortality in hematogenous vertebral osteomyelitis

Clinical Results Of A Lamina With Spinous Process And An Iliac Graft As Bone Grafts In The Surgical Treatment Of Single-Segment Lumbar Pyogenic Discitis: A Retrospective Cohort Study

Interface Polarization Strengthened Microwave Catalysis of MoS2/FeS/Rhein for the Therapy of Bacteria‐Infected Osteomyelitis

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Interface Polarization Strengthened Microwave Catalysis of MoS₂/FeS/Rhein for the Therapy of Bacteria‐Infected Osteomyelitis