title: Does Pathogen Identification Influence the Clinical Outcomes in Patients With Pyogenic Spinal Infections?
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To study the clinical outcomes of patients suffering from pyogenic spinal infections (PSI), by comparing the outcomes of patients with an identified microbiological agent with those of patients without an identified pathogen.
  
  
  BACKGROUND
  PSI is associated with significant risks for morbidity and mortality. Specific antibiotic treatment has been considered a key to successful medical treatment; however, clinicians frequently treat patients with PSI without an identified agent. A paucity of data is available comparing the clinical outcomes of patients with or without an identified pathogen.
  
  
  METHODS
  The records of 97 consecutive patients discharged from a University Hospital with the diagnosis of PSI during a 14-year period were retrospectively reviewed. Patients' demographics, etiological agent, comorbidities, site of infection, white blood cell count, erythrocyte sedimentation rate, C-reactive protein at the time of presentation, neurological impairment, length of hospital stay, and mortality were registered to compare the clinical outcomes of patients with an identified pathogen with those of patients without an identified agent.
  
  
  RESULTS
  The causative organism was identified in 74 patients (76.3%). Patients with microbiological diagnosis were younger, and a larger percentage of them exhibited elevated C-reactive protein value; however, they were not different from those without an identified agent in terms of sex, site of infection, comorbidities, and the presence of a concomitant infection. Our study could not demonstrate different neurological outcomes, length of stay, or mortality rates among the 2 groups.
  
  
  CONCLUSIONS
  In a large series of patients with PSI, we did not demonstrate differences in clinical outcomes using empirical antibiotics in patients without an identified pathogen compared with patients with an identified microbiological agent receiving specific antibiotics. Future prospective multicenter studies should be conducted to obtain an answer to this important clinical question.
authors.affiliation: Departments of *Orthopaedic Surgery †Clinical Laboratories, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
authors.forename: Julio
authors.initials: J
authors.lastname: Urrutia
authors.forename: Mauricio
authors.initials: M
authors.lastname: Campos
authors.forename: Tomas
authors.initials: T
authors.lastname: Zamora
authors.forename: Valentina
authors.initials: V
authors.lastname: Canessa
authors.forename: Patricia
authors.initials: P
authors.lastname: Garcia
authors.forename: Jorge
authors.initials: J
authors.lastname: Briceno
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D007902:Length of Stay; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D010019:Osteomyelitis / Q000188:drug therapy / Q000382:microbiology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012189:Retrospective Studies; D012737:Sex Factors; D013122:Spinal Diseases / Q000188:drug therapy* / Q000382:microbiology* / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein