Polymicrobial and Monomicrobial Infections after Spinal Surgery: A Retrospective Study to Determine which Infection is more Severe

Shaoqiang Liu; Qiang Qi; Zhongqiang Chen; Ning Liu; Zhaoqing Guo; Chuiguo Sun; Weishi Li; Yan Zeng; Zhongjun Liu

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자료유형: 학술저널

저자정보: Shaoqiang Liu (Peking University Third Hospital) Qiang Qi (Peking University Third Hospital) Zhongqiang Chen (Peking University Third Hospital) Ning Liu (Peking University Third Hospital) Zhaoqing Guo (Peking University Third Hospital) Chuiguo Sun (Peking University Third Hospital) Weishi Li (Peking University Third Hospital) Yan Zeng (Peking University Third Hospital) Zhongjun Liu (Peking University Third Hospital)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.11 No.3

발행연도: 2017.1

수록면: 427 - 436 (10page)

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Study Design: A retrospective clinical review. Purpose: To investigate the difference in clinical manifestations and severity between polymicrobial and monomicrobial infections after spinal surgery. Overview of Literature: Surgical site infections (SSIs) after spinal surgery are a major diagnostic and therapeutic challenge for spinal surgeons. Polymicrobial infections after spinal surgery seem to result in poorer outcomes than monomicrobial infections because of complementary resistance to antibiotics. However, comparison of the clinical manifestations and severity between polymicrobial and monomicrobial infections are limited. Methods: Sixty-seven patients with SSIs after spinal surgery were studied: 20 patients with polymicrobial infections and 47 with monomicrobial infections. Pathogenic bacteria identified were counted and classified. Age, sex, and body mass index were compared between the two groups to identify homogeneity. The groups were compared for clinical manifestations by surgical site, postoperative time to infection, infection site, incisional drainage, incisional swelling, incisional pain, neurological signs, temperature, white blood cell count, and the percentage of neutrophils. Finally, the groups were compared for severity by hospital stay, number of rehospitalizations, number of debridements, duration of antibiotics administration, number of antibiotics administered, and implant removal. Results: Polymicrobial infections comprised 29.9% of SSIs after spinal surgery, and most polymicrobial infections (70.0%) were caused by two species of bacteria only. There was no difference between the groups in terms of clinical manifestations and severity. In total, 96 bacterial strains were isolated from the spinal wounds: 60 strains were gram-positive and 36 were gram-negative pathogenic bacteria. Staphylococcus aureus , Staphylococcus epidermidis , Escherichia coli , and Enterobacter cloacae were cultured in order of the frequency of appearance. Conclusions: Most polymicrobial infections were caused by two bacterial species after spinal surgery. There was no difference in clinical manifestations or severity between polymicrobial and monomicrobial infections.

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