[Spondylodiscitis: clinical experience in a Chilean general hospital].
BACKGROUND
Spondylodiscitis (SD) involves long periods of hospitalization, diagnostic latency and risk of long-term complications. No updated series are available in Chile and a change in demographic features and etiology is suspected.


OBJECTIVE
To characterize a group of patients with SD.


METHODS
Clinical series including patients over an 8 year period.


RESULTS
We identified 37 patients; 37.8% women and 62.2% men (mean age 66.8 years); 64.9% were elderly; 35.1% had diabetes and 21.6% urological comorbidity. Main symptoms were pain and fever. Erythrocyte sedimentation rate was elevated in 89.2%, and 86.5% patients had MRI, which was always confirmatory. Lumbar spine was the most common site of infection (43.2%). Etiology was identified in 28/37 patients: 71.4% yielded grampositive cocci (Staphylococcus aureus predominantly), Mycobacterium tuberculosis was identified in only 10.7%. Staphylococcus aureus was associated to medical comorbidities (p < 0,05) and gramnegative bacilli to hepatobiliar or intestinal symptoms (p < 0,05). Culture obtained by a surgical procedure had the highest yield. The average duration of antibiotic therapy was 63.8 days (IQR 53-72). Treatment-related side effects were detected in 18.9% of patients. The average hospital stay was 38.9 days. No deaths occurred during hospitalization. Motor sequelae were present in 18.9% of this series.


CONCLUSIONS
Most patients with SD were older adults. Staphylococcus aureus was predominant and M. tuberculosis was uncommon. Antibiotic side effects were relevant as well as the neurological complications.
Servicio de Infectología, Departamento de Medicina, Hospital Militar de Santiago, Chile, andresfsoto@gmail.com.
Andrés
A
Soto
Servicio de Infectología, Departamento de Medicina, Hospital Militar de Santiago, Chile.
Alberto
A
Fica
Servicio de Infectología, Departamento de Medicina, Hospital Militar de Santiago, Chile.
Jeannette
J
Dabanch
Facultad de Medicina, Universidad de los Andes, Chile.
Felipe
F
Olivares
Laboratorio de Microbiología, Departamento de Medicina, Hospital Militar de Santiago, Chile.
Lorena
L
Porte
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002677:Chile / Q000453:epidemiology; D015897:Comorbidity; D015299:Discitis / Q000453:epidemiology* / Q000382:microbiology* / Q000628:therapy; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013122:Spinal Diseases / Q000453:epidemiology / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D016896:Treatment Outcome; D055815:Young Adult