TITLE:
Analytic Study of Spinal Infections: Clinical Picture, Treatment, and Outcomes in King Fahad Military Medical Complex in Dhahran, Saudi Arabia
AUTHORS:
Salma Albahrani, Amal Shilash, Ayat Albasri, Sharifah Almuthen, Sama Tawfiq, Khalid Alzahrani, Amjad Darwish, Muneera Albassam, Jamil Barhoun
KEYWORDS:
Spinal Infection, Mycobacterium tuberculosis, Quambalaria cyanescens, Tuberculosis, Spondylodiscitis
JOURNAL NAME:
Open Journal of Medical Microbiology,
Vol.10 No.3,
July
1,
2020
ABSTRACT: Objective: To evaluate the
prevalence of spinal infection in a hospital located in the eastern region of
Saudi Arabia through a retrospective review and to identify the associated
etiological agents in terms of clinical picture, treatment, and outcomes. Design: Retrospective cross-sectional study. Setting: Single hospital in
Dhahran, Saudi Arabia. Patients: Patients with any type of spinal
infection and/or who had undergone neurosurgical intervention for spinal
infection between January 2006 and December 2018. Methods: We collected
data on all patients with an established diagnosis of spinal infection from
January 2006 to December 2018 in the King Fahad Military Medical Complex in
Dhahran, Saudi Arabia. A validated and structured checklist was used for data
collection. Spinal infection diagnosis was based on the clinical manifestation,
microbiological evidence, radiological findings, and antimicrobial therapy
response. Results: Seventeen patients were included in this study, and
their mean age was 54.93 years. Twelve of the patients were male and four were
female. The approximate time from symptom onset to diagnosis was 2 - 6 months. Most of the patients experienced back pain, with lumbosacral
spondylitis being the most commonly cited type (61.11%), followedby thoracolumbar spondylodiscitis (25%) and cervical
spondylodiscitis (6.25%). The most frequently isolated organism was Mycobacterium
tuberculosis (8 patients, 50%), followed by extended-spectrum beta lactamase
(ESBL)-producing Escherichia coli (4 patients, 25%), Brucella spp
(3 patients, 18.75%), Staphylococcus aureus (1 patient, 6.25%), and Quambalaria
cyanescens (1 patient, 6.25%). Totally, in 50% of the patients with
thoracolumbar and lumbosacra site involvement, tuberculosis spondylodiscitis
was observed, while another 50% of the cases showed complications associated
with paravertebral abscess that required surgical drainage. Conclusion: M. tuberculosis was found to be the major cause of
infectious spondylodiscitis. Additionally, Quambalaria cyanescens was
isolated; this is the second reported case of the organism being isolated and
the first associated with spinal infection.