Usefulness of Percutaneous Drainage in Determining the Causative Microorganism in Patients with Spondylodiscitis: A Retrospective Cross-Sectional Study

Overview

Journal J Belg Soc Radiol

Publisher Ubiquity Press

Specialty Radiology

Date 2023 Jul 17

PMID 37457675

Authors

Shoichi Ikenaga

Daisuke Yunaiyama

Mika Yasutomi

Itaru Nakamura

Mitsuru Okubo

Toru Saguchi

Motoki Nakai

Kazuhiro Saito

Affiliations

Soon will be listed here.

Abstract

Purpose: To determine the usefulness of CT-guided percutaneous drainage for the causative microorganism detection in patients with spondylodiscitis.

Materials And Methods: Data of patients who underwent CT-guided percutaneous drainage for spondylodiscitis from January 2014 to April 2022 were extracted from the radiological database of our hospital and investigated. The administration rate of antibiotics prior to blood culture and CT-guided percutaneous drainage (CTPD) were analyzed. The detection rate of microorganisms via blood culture and CT-guided percutaneous drainage were compared using the Mann-Whitney's U test with the SPSS software.

Results: In this study, a total of 30 (20 male and 10 female) patients were analyzed. A total of 13 patients (43%) were administered antibiotics prior to blood culture. Of them, microorganisms were detected via blood culture in only one patient (7%). A total of 25 patients (83%) were administered antibiotics prior to CTPD. Of them, the causative microorganisms in 19 patients (76%) were detected. Overall, the causative microorganism could be detected in 24 out of 26 patients (92%) via CT-guided percutaneous drainage. There was a statistical significance in the detection rate of microorganisms between blood culture and CTPD (P = 0.004) in favor of CTPD.

Conclusion: CT-guided percutaneous drainage showed a high positive rate of microorganism detection in patients with spondylodiscitis regardless of antibiotic administration prior to the procedure. CT-guided percutaneous drainage can be a solution for the detection of the causative microorganism in spondylodiscitis patients who received antibiotics before obtaining any culture.

References

Shenoy K, Singla A, Krystal J, Razi A, Kim Y, Sharan A . Discitis in Adults. JBJS Rev. 2018; 6(6):e6. DOI: 10.2106/JBJS.RVW.17.00104. View

McNamara A, Dickerson E, Gomez-Hassan D, Cinti S, Srinivasan A . Yield of Image-Guided Needle Biopsy for Infectious Discitis: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol. 2017; 38(10):2021-2027. PMC: 7963615. DOI: 10.3174/ajnr.A5337. View

Grammatico L, Baron S, Rusch E, Lepage B, Surer N, Desenclos J . Epidemiology of vertebral osteomyelitis (VO) in France: analysis of hospital-discharge data 2002-2003. Epidemiol Infect. 2007; 136(5):653-60. PMC: 2870846. DOI: 10.1017/S0950268807008850. View

Berbari E, Kanj S, Kowalski T, Darouiche R, Widmer A, Schmitt S . 2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults. Clin Infect Dis. 2015; 61(6):e26-46. DOI: 10.1093/cid/civ482. View

Seigel T, Cocchi M, Salciccioli J, Shapiro N, Howell M, Tang A . Inadequacy of temperature and white blood cell count in predicting bacteremia in patients with suspected infection. J Emerg Med. 2010; 42(3):254-9. DOI: 10.1016/j.jemermed.2010.05.038. View

Pola E, Autore G, Formica V, Pambianco V, Colangelo D, Cauda R . New classification for the treatment of pyogenic spondylodiscitis: validation study on a population of 250 patients with a follow-up of 2 years. Eur Spine J. 2017; 26(Suppl 4):479-488. DOI: 10.1007/s00586-017-5043-5. View

Hopkinson N, Patel K . Clinical features of septic discitis in the UK: a retrospective case ascertainment study and review of management recommendations. Rheumatol Int. 2016; 36(9):1319-26. DOI: 10.1007/s00296-016-3532-1. View

Ackerman T, Singer-Jordan J, Shani A, Rahamimov N . Intra-discal drain insertion for culture and drainage of pyogenic spondylodiscitis: A one-step diagnostic and therapeutic procedure. Interv Neuroradiol. 2019; 26(1):105-110. PMC: 6998002. DOI: 10.1177/1591019919885557. View

Zimmerli W . Clinical practice. Vertebral osteomyelitis. N Engl J Med. 2010; 362(11):1022-9. DOI: 10.1056/NEJMcp0910753. View

10.

Scheer C, Fuchs C, Grundling M, Vollmer M, Bast J, Bohnert J . Impact of antibiotic administration on blood culture positivity at the beginning of sepsis: a prospective clinical cohort study. Clin Microbiol Infect. 2018; 25(3):326-331. DOI: 10.1016/j.cmi.2018.05.016. View

11.

Staatz G, Adam G, Keulers P, Vorwerk D, Gunther R . Spondylodiskitic abscesses: CT-guided percutaneous catheter drainage. Radiology. 1998; 208(2):363-7. DOI: 10.1148/radiology.208.2.9680560. View

12.

Nickerson E, Sinha R . Vertebral osteomyelitis in adults: an update. Br Med Bull. 2016; 117(1):121-38. DOI: 10.1093/bmb/ldw003. View

13.

Gouliouris T, Aliyu S, Brown N . Spondylodiscitis: update on diagnosis and management. J Antimicrob Chemother. 2010; 65 Suppl 3:iii11-24. DOI: 10.1093/jac/dkq303. View