Culture-negative versus culture-positive in pyogenic spondylitis and analysis of risk factors for relapse

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.

Keywords:

• Culture negative
• culture positive
• pyogenic spondylitis
• diagnosis
• treatment
• prognosis

Acknowledgments

The authors thank Spinal surgery staff, Affiliated Hospital of Qingdao University, China for their assistance and advice.

Ethics approval

This study was approved by the ethics committees of Affiliated Hospital of Qingdao University.

Informed consent

All patients involved gave written informed consent to review their medical records. All personal details were erased before analysis to cover patient data confidentiality and comply with the Declaration of Helsinki.

Consent for publication

Written informed consent was obtained from all of the patients for publication of this research and any accompanying images.

Disclosure statement

The authors declare that they have no conflict of interest.

Data availability statement

All the data and material can be available from Dai guohua and Wang ting for reasonable request.