title: Epidemiologic and Demographic Attributes of Primary Spondylodiscitis in a Middle Eastern Population Sample.
abstract: BACKGROUND
  The prevalence and characteristics of spontaneous spondylodiscitis in the Middle East are unknown. There seems to be an emerging dominance of pyogenic infections over tuberculosis and brucellosis.
  
  
  METHODS
  We conducted a retrospective observational study based on electronic case records of 4 years from a tertiary reference facility in Oman. Case records, microbiology reports, blood reports, imaging studies, and histopathology, and surgical reports of all spinal infection cases were studied. Patients with secondary infections after invasive spinal interventions and expatriate patients were excluded. Risk factors and comorbidities were also analyzed.
  
  
  RESULTS
  Sixty-two cases of primary spondylodiscitis of the spine were identified in this cohort, including 10 cases of tuberculosis, 1 of brucellosis, and 1 of tuberculosis with pyogenic infection. Of the 50 pyogenic infections, 4 were in children; among the adults, the mean age was 49.5 years and 63.8% were male. Thirty-three patients had no medical comorbidities. Common ailments associated were 18 patients with diabetes mellitus, 13 hypertensives, 6 with renal insufficiency, 2 with liver cirrhosis, 3 with alcoholism, 5 with hepatitis C virus, and 2 with immunosuppression. More than 69% involvement was in the lumbar spine. Fourteen patients were infected with Staphylococcus aureus and 9 with Pseudomonas aeruginosa, whereas 35.4% were culture negative.
  
  
  CONCLUSIONS
  Spontaneous infective spondylodiscitis affects older men with and without medical comorbidities equally. It often involves the lumbar spine and a third of patients are culture negative. Tuberculosis constitutes only about 17% of primary infections in the spine in this population sample.
authors: Department of Orthopaedics, Khoula Hospital, Mina Al Fahal, Muscat, Sultanate of Oman. Electronic address: kvm422@gmail.com.
authors: K Venugopal
authors: KV
authors: Menon
authors: Department of Orthopaedics, Khoula Hospital, Mina Al Fahal, Muscat, Sultanate of Oman.
authors: Tamer Malak Moawad
authors: TM
authors: Sorour
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002006:Brucellosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015299:Discitis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D008877:Middle East / Q000453:epidemiology; D015995:Prevalence; D011552:Pseudomonas Infections / Q000453:epidemiology*; D011550:Pseudomonas aeruginosa; D012189:Retrospective Studies; D017678:Sex Distribution; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013211:Staphylococcus aureus; D014399:Tuberculosis, Spinal / Q000453:epidemiology*; D055815:Young Adult
keywords: Disc space infection; Infective spondylitis; Pyogenic infection; Spondylodiscitis; Vertebral osteomyelitis