Clinical characteristics and surgical outcomes of pyogenic vertebral osteomyelitis caused by carbapenem-resistant Enterobacteriaceae.

BACKGROUND

Pyogenic vertebral osteomyelitis (PVO) caused by Carbapenem-resistant Enterobacteriaceae (CRE) represents a formidable clinical challenge. The current understanding of the clinical characteristics and surgical outcomes for this infection is limited. This study aims to delineate the profile of CRE pyogenic vertebral osteomyelitis and assess the efficacy of surgical intervention.

METHODS

We retrospectively reviewed 256 patients who underwent surgery for PVO. Clinical characteristics and postoperative complications within one year were compared between patients with PVO caused by CRE and those caused by other organisms (Non-CRE). Multiple logistic analysis was performed to determine independent factors associated with inadequate treatment response (ITR), which was defined as clinical, microbiological, and/or radiological progression during treatment.

RESULTS

CRE patients had a higher incidence of diabetes, thoracic spine involvement, pneumonia and higher ESR, longer time from diagnosis to surgery, and longer hospital length of stay. They also had higher rates of overall readmission, ITR and death. Hypoproteinemia, surgical history and CRE were independent risk factors for ITR.

CONCLUSION

PVO caused by CRE were associated with a higher prevalence of diabetes, thoracic spine involvement, and pneumonia. Moreover, hypoproteinemia, surgical history and CRE were independent risk factors for ITR.