Abstract
Objectives This study aims to compare and analyze the clinical features, diagnosis, treatment and prognosis of culture-negative and culture-positive primary pyogenic spondylitis. Methods In a retrospective analysis, 202 cases of adult primary pyogenic spondylitis with complete clinical data in our hospital from January 2013 to January 2020 were divided into two groups according to bacterial culture results: culture negative (n = 126) and culture positive (n = 76). We compare the clinical characteristics, diagnosis, treatment and prognosis of patients with different culture results. Results The culture positive rate was 37.62% (76/202). There were no significant differences in age, gender, affected segment, spinal abscess, diabetes mellitus, course of disease, surgery, recurrence, and follow-up time between the two groups (p>.05). There were statistically significant differences in hospital admission erythrocyte sedimentation rate (ESR), admission C-reactive protein (CRP), admission white blood cell (WBC) count, discharge ESR, discharge CRP, ESR decline rate, CRP (p<.05). There were statistically significant differences in the rate of decline, hospitalization days, and body temperature ≥38 °C (p<.05). Higher CRP levels on admission, antibiotic treatment time <6 weeks, and body temperature ≥ 38 °C are independent risk factors for infection recurrence. Conclusions The culture-negative group's admission WBC, admission ESR, admission CRP, discharge ESR, discharge CRP, ESR decline rate, CRP decline rate, and hospital stay were lower than the culture positive group, the difference was statistically significant (p<.05). The independent risk factors for infection recurrence are higher CRP levels in hospital admission, antibiotic treatment time <6 weeks, and body temperature ≥ 38 °C.
Highlights
Pyogenic spondylitis is a type of non-specific spondylitis caused by bacterial infection, mainly involving the spine and intervertebral discs
Some recent studies have found that the number of patients with purulent spondylitis with negative bacterial culture is increasing year by year [3, 4], current literature research Mostly focus on the infection around the joint prosthesis [5], and there are few studies on spondylitis with negative bacterial culture
The identification of microorganisms is the key to guiding the standardized treatment of pyogenic spondylitis
Summary
Pyogenic spondylitis is a type of non-specific spondylitis caused by bacterial infection, mainly involving the spine and intervertebral discs. It can be divided into a group of diseases such as discitis, vertebral osteomyelitis, and epidural abscess [1]. Studies have reported the clinical features and results of culture-negative purulent spondylitis [7]. The treatment of patients with culture-negative purulent spondylitis mainly relies on empirical medication [8], and there is no established standard Treatment principles. This study focuses on the analysis of the clinical features, diagnosis, treatment and prognosis of culture-negative purulent spondylitis
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