Predictive Factors of Cloxacillin Susceptibility in Primary Bacterial Spinal Infection.
Global Spine J
; : 21925682241251814, 2024 May 06.
Article
em En
| MEDLINE
| ID: mdl-38710111
ABSTRACT
STUDY DESIGN:
Prognostic study.OBJECTIVES:
The objective of this study is to identify predictive factors for cloxacillin susceptibility in spinal infections.METHODS:
A retrospective analysis was conducted using data from January 1, 1997, to December 31, 2021. The study included patients presenting with back pain and either a positive bacterial culture from the spine or radiological evidence of spinal infection (spondylodiscitis and/or epidural abscess) along with positive bacterial blood culture.RESULTS:
Among 171 patients (127 males, 44 females), 53.2% had Staphylococcus isolates, with 40.4% showing cloxacillin resistance. Lower globulin levels (<33.5 g/L), recent hospitalization within 90 days, and residence in an old age home predicted gram-positive bacteria with cloxacillin resistance and gram-negative bacteria as causative organisms (P<.05). The 30-day and 1-year all-cause mortality rates were 0% and 8.2%, respectively. Higher red cell distribution width (RDW >16.1%) and Charlson comorbidity index (CCI) scores predicted 1-year all-cause mortality (P<.05). Intensive care unit admission was required for 9.9% of patients.CONCLUSIONS:
This study identified predictive factors for spinal infection by gram-positive bacteria with cloxacillin resistance and gram-negative bacteria. Patients with lower globulin levels (<33.5 g/L), recent hospitalization within 90 days, or residency in an old age home upon admission should avoid standalone cloxacillin therapy and consider antibiotics with gram-negative coverage. Higher RDW (>16.1%) and CCI scores were associated with increased 1-year all-cause mortality. These findings contribute to treatment decision-making and improving patient outcomes in spinal infections.
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Base de dados:
MEDLINE
Idioma:
En
Revista:
Global Spine J
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
China