ABSTRACT
Objective: Infectious spondylodiscitis [SD] is an infectious disease that is rare and difficult to diagnose due to its non-specific clinical features. In this study, we aimed to describe the clinical and diagnostic features of infectious spondylodiscitis
Methods: All patients who were diagnosed with SD at our hospital during a 7-year period from January 1, 2011 through December 31, 2017 were included in the study. Spondylodiscitis is divided into the following three types: pyogenic, tuberculous, and brucellar. Clinical and laboratory data were collected retrospectively from the medical records of the patients
Results: Of the 118 patients, 66 [55.9%] were female, 81 [68.6%] had pyogenic SD [PSD], 21 [17.8%] had tuberculous SD [TSD], and 16 [13.6%] had brucellar SD [BSD]. The mean age was 59.3 +/- 14.6 years. Leucocytosis was significantly higher in patients with PSD [p=0.01] than in patients with other types of SD. Thoracic involvement [47.6%] was significantly higher in patients with TSD [p=0.005] than in other patients. Sacral involvement [12.5%] was significantly higher in patients with BSD [p=0.01] than in other patients. Paravertebral abscess formation [42.8%] occurred most frequently in patients with TSD. Microbiologic agents were defined in 50% [18/36] of the surgical specimens and in 12.5% of the fine needle aspiration biopsy [FNAB] specimens. Staphylococcus aureus was the most common microbiological agent in patients with PSD. Spinal surgery was defined as a risk factor for PSD [p = 0.0001]. Binary logistic regression analysis revealed that female gender, thoracic involvement and night sweats were the predictive markers for TSD [OR 4.5 [95% CI 1.3-15.3] and OR 5 [95% CI 1.7-14.6]]
Conclusion: PSD is the most frequent form of SD. Leucocytosis is most common in patients with PSD. Thoracic involvement and paraspinal abscess were prominent in patients with TSD. Sacral involvement was most common in patients with BSD. Thoracic involvement, female gender and night sweats were the predictive markers for TSD. The microbiological culture positivity rate was higher in surgical specimens compared to FNAB specimens. The need for surgical treatment was most common in patients with TSD
ABSTRACT
Objectives: In the intensive care setting, Acinetobacter baumannii causes ventilator-associated pneumonia and other nosocomial infections that are difficult to treat. Objective of this study was to investigate nosocomial A. baumannii infections and its changing antibiotic resistance
Methods: A total of 56 patients diagnosed with A.baumannii infections between January 2009 and December 2011 were included in the study. Diagnosis for nosocomial infections was established according to the CDC [Centers for Disease Control and Prevention] criteria. Identification of the agents isolated was carried out using conventional methods and VITEK 2 automated system, while antibiotic sensitivity testing was performed through VITEK 2 AST-N090 automated system
Results: The most common infection was nosocomial pneumonia by 43%, among which 46% were ventilatorassociated pneumonia. Considering all years, the most effective antibiotics on the isolated strains were found as colistin, tigecycline, imipenem and meropenem. However resistance to imipenem and meropenem was observed to increase over years
Conclusion: The issue of increased resistance to antibiotics poses difficulty in treatment of A. baumannii infections which in turn increases the rate of mortality and cost. In order to prevent development of resistance, antibiotics must be used in an appropriate way in accompanied with proper guidance