Tigecycline in the management of post-neurosurgical spondylodiscitis: a review of eight cases

Sıpahi, Oğuz Reşat; Kahraman, Hasip; Mermer, Sinan; Pullukçu, Hüsnü; Taşbakan, Meltem; Arda, Bilgin; Yurtseven, Taşkın; Aydemir, Şöhret; Ulusoy, Sercan

doi:10.1016/j.ijid.2014.01.027

Cited by 12 publications

(6 citation statements)

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“…Sipahi et al . reported a case of postoperative spondylodiscitis due to MDR A. baumannii [5]. This patient received intravenously administered tigecycline for a total of 45 days, and was discharged with orally administered doxycycline, netilmicin, and sulbactam.…”

Section: Discussionmentioning

confidence: 99%

Prolonged and high dosage of tigecycline – successful treatment of spondylodiscitis caused by multidrug-resistant Acinetobacter baumannii: a case report

et al. 2017

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BackgroundThe incidence of infectious spondylodiscitis has been increasing over the last few years. This reflects the expanding elderly and immunocompromised populations and the rising implementation of invasive spinal procedures. Infection may be inoculated into the disc space directly during invasive spinal procedures. Osteomyelitis caused by Acinetobacter species is rare and mainly caused by multidrug-resistant strains.Case presentationWe present the case of a 72-year-old Greek woman with postoperative spondylodiscitis caused by a multidrug-resistant Acinetobacter baumannii strain that was successfully treated, after she declined surgical treatment, with prolonged and high dosage of tigecycline. She received intravenously administered tigecycline 200 mg per day for 60 days and then 100 mg per day for a total of 102 days and was infection-free.ConclusionsWe reviewed the literature on the role of Acinetobacter baumannii as a cause of osteomyelitis, emphasizing the difficulty of treatment and the potential role of tigecycline in conservative treatment of the infection. We believe that 102 days in total is the longest time that any patient has received tigecycline in the literature, thus our patient is a unique case of successful treatment of spondylodiscitis.

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Section: Discussionmentioning

confidence: 99%

Prolonged and high dosage of tigecycline – successful treatment of spondylodiscitis caused by multidrug-resistant Acinetobacter baumannii: a case report

et al. 2017

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“…The United States Food and Drug Administration (FDA) approved tigecycline for the treatment of complicated intra-abdominal infections, complicated skin and skin structure infections and community-acquired pneumonia. However, its off-label use in other CRAB infections such as nosocomial pneumonia, bacteremia or meningitis is common due to its pharmacological profile and bacterial spectrum [5][6][7][8][9][10]. In this multicenter study, we retrospectively reviewed A. baumannii meningitis cases treated with tigecycline including regimens and evaluated the efficacy of tigecycline in the therapy.…”

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confidence: 99%

“…In spite of developments in neurosurgery, antimicrobial agents, medicine and intensive care, meningitis, as well as nosocomial or healthcare-associated meningitis (HCAM), are still associated with significant mortality and morbidity[1][2][3][4][5][6][7][8][9][10][11]. Multidrug-resistant (MDR) as well as carbapenem-resistant Acinetobacter baumannii (CRAB)…”

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confidence: 99%

Tigecycline in the treatment of multidrug-resistant Acinetobacter baumannii meningitis: Results of the Ege study

Sıpahi

Mermer

Demırdal

et al. 2018

Clinical Neurology and Neurosurgery

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“…It may develop primarily or as a healthcareassociated infection following spinal surgeries [1] .Tuberculosis (TB) is still endemic in Turkey, and can cause extrapulmonary involvement in various systems. One of the common sites of extrapulmonary TB is bone, with 10% of cases having vertebral involvement.…”

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confidence: 99%

“…Spondylodiscitis, or infections affecting both the intervertebral discs and the vertebrae, may arise due to pyogenic infections, brucellosis, or TB [1] . The differential diagnosis of primary spondylodiscitis includes mycobacteria; pyogenic and fungal infections due to Staphylococcus aureus, Cryptococcus spp., and Actinomyces spp.…”

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A Case Report: Mycobacterium fortuitum Spondylodiscitis

Mermer¹,

Çavuşoğlu²,

Özcem³

et al. 2018

mjima

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Spondylodiscitis refers to infection of both the intervertebral disc and vertebrae. It may develop primarily or as a healthcareassociated infection following spinal surgeries [1] .Tuberculosis (TB) is still endemic in Turkey, and can cause extrapulmonary involvement in various systems. One of the common sites of extrapulmonary TB is bone, with 10% of cases having vertebral involvement. Nontuberculous mycobacterial (NTM) infections are usually sporadic. Of the NTM, Mycobacterium fortuitum, is rarely an infectious agent, but can cause infections after trauma or surgery, especially infections associated with orthopedic implants [2] . Herein, we present a case of spondylodiscitis due to M. fortuitum.A 44-year-old female patient with no known chronic disease underwent surgery at another center in 2000 and 2007 due to a herniated disc at L4-L5. Approximately one month after the second surgery, she presented to the neurosurgery clinic of our hospital due to increased pain in her lower back and legs. Examination and imaging revealed lumbar stenosis at L4-L5, and the patient underwent L4-L5 laminectomy and L4-L5-S1 posterior fixation. Five months after discharge, the patient presented to a private medical center for persistent leg and lower back pain and underwent a fourth operation. Some of the screws at L4 appeared infected and were removed during the procedure. Afterwards, she was given an antibiotic for over three weeks, but she did not know the name of it. The patient's complaints of pain in the legs and lower back persisted during the first postoperative month. Lumbar magnetic resonance imaging (MRI) showed an abscess formation with peripheral enhancement, over 5 cm in diameter, extending to the L5-S1 pedicular screws and under the skin posterior to L4-L5. The patient was readmitted to the neurosurgery clinic of our hospital and underwent abscess drainage and debridement. Rose Bengal test performed at this time was negative. A specimen taken from the abscess was analyzed with bacterial culture, mycological culture, TB culture, acid-fast bacillus (AFB) staining, and pathological examination. Bacterial and mycological cultures did not yield any pathogen and AFB staining was negative. Inflammatory granulation tissue was observed in pathological examination. Consultation was requested due to the patient's negative cultures; the patient was started on empirical ceftriaxone and teicoplanin therapy and transferred to Infectious Diseases Clinic postoperatively. After nearly one month of antibiotherapy with ceftriaxone and teicoplanin and follow-up in our clinic, recurrent abscess was observed on control lumbar MRI. The patient was transferred

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Tigecycline in the management of post-neurosurgical spondylodiscitis: a review of eight cases

Abstract: These limited data suggest that tigecycline may have a role in the treatment of refractory spondylodiscitis cases.

Cited by 12 publications

References 9 publications

Prolonged and high dosage of tigecycline – successful treatment of spondylodiscitis caused by multidrug-resistant Acinetobacter baumannii: a case report

Prolonged and high dosage of tigecycline – successful treatment of spondylodiscitis caused by multidrug-resistant Acinetobacter baumannii: a case report

Tigecycline in the treatment of multidrug-resistant Acinetobacter baumannii meningitis: Results of the Ege study

A Case Report: Mycobacterium fortuitum Spondylodiscitis

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