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Article: Infective spondylitis in Southern Chinese: A descriptive and comparative study of ninety-one cases

TitleInfective spondylitis in Southern Chinese: A descriptive and comparative study of ninety-one cases
Authors
KeywordsPyogenic
Risk factors
Spine
Spondylitis
Symptoms
Tuberculosis
Vertebral osteomyelitis
Issue Date2010
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2010, v. 35 n. 6, p. 635-641 How to Cite?
AbstractStudy Design. A retrospective review of infective spondylitis patients assessed at a major, tertiary referral centre in Hong Kong. Objective. To assess the prevalence, risk factors, clinical features, and prognostic outcomes associated with tuberculous spondylitis to that of pyogenic spondylitis in Southern Chinese treated at a single institution. Summary of Background Data. Previous studies in Asia suggest that tuberculous spondylitis is the predominant infection unless proven otherwise. Current clinical experiences suggest otherwise; however, the current trend and clinical profile of infective spondylitis among Southern Chinese remains speculative with no published studies examining their prevalence. Methods. A retrospective review was performed of all infective spondylitis cases presenting from January 2004 to July 2008 to a tertiary referral center. Cases were included on the basis of clinical and microbiological criteria. Radiographic imaging was used for further confirmation. Results. Ninety-one patients were identified. Overall, tuberculous spondylitis and pyogenic spondylitis entailed 22 (24.2%) and 69 (75.8%) cases, respectively. Staphylococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis. Individuals with pyogenic spondylitis were significantly much older than those with tuberculous spondylitis (P = 0.001). Intravenous drug addiction was the most commonly noted risk factor followed by diabetes, and found to be more prevalent in pyogenic spondylitis cases. At initial presentation, white cell count and c-reactive protein levels were higher in pyogenic spondylitis cases compared with tuberculous spondylitis (P < 0.05). The occurrence of tuberculous spondylitis cases was predominant in the thoracic region (40.9%) (P < 0.05). Surgical intervention was performed in 54.5% of tuberculous spondylitis and in 24.6% of the pyogenic spondylitis cases (P = 0.009). Conclusion. In Southern Chinese, compared to previous reports over the past 3 decades, a changing prevalence of decreasing tuberculous spondylitis was observed. Pyogenic spondylitis was found to be more common among patients hospitalized for infective spondylitis. This has important implications on the method of diagnosis and the need for establishing microbiological diagnosis before commencing treatment. "Best guess" therapy should not be targeted at tuberculous spondylitis only. There are clear distinctions in the biologic and clinical profiles between tuberculous and pyogenic spondylitis that would help to direct therapy. © 2010, Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/125157
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYee, DKHen_HK
dc.contributor.authorSamartzis, Den_HK
dc.contributor.authorWong, YWen_HK
dc.contributor.authorLuk, KDKen_HK
dc.contributor.authorCheung, KMCen_HK
dc.date.accessioned2010-10-31T11:14:42Z-
dc.date.available2010-10-31T11:14:42Z-
dc.date.issued2010en_HK
dc.identifier.citationSpine, 2010, v. 35 n. 6, p. 635-641en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/125157-
dc.description.abstractStudy Design. A retrospective review of infective spondylitis patients assessed at a major, tertiary referral centre in Hong Kong. Objective. To assess the prevalence, risk factors, clinical features, and prognostic outcomes associated with tuberculous spondylitis to that of pyogenic spondylitis in Southern Chinese treated at a single institution. Summary of Background Data. Previous studies in Asia suggest that tuberculous spondylitis is the predominant infection unless proven otherwise. Current clinical experiences suggest otherwise; however, the current trend and clinical profile of infective spondylitis among Southern Chinese remains speculative with no published studies examining their prevalence. Methods. A retrospective review was performed of all infective spondylitis cases presenting from January 2004 to July 2008 to a tertiary referral center. Cases were included on the basis of clinical and microbiological criteria. Radiographic imaging was used for further confirmation. Results. Ninety-one patients were identified. Overall, tuberculous spondylitis and pyogenic spondylitis entailed 22 (24.2%) and 69 (75.8%) cases, respectively. Staphylococcus aureus was the most commonly isolated infective agent associated with pyogenic spondylitis. Individuals with pyogenic spondylitis were significantly much older than those with tuberculous spondylitis (P = 0.001). Intravenous drug addiction was the most commonly noted risk factor followed by diabetes, and found to be more prevalent in pyogenic spondylitis cases. At initial presentation, white cell count and c-reactive protein levels were higher in pyogenic spondylitis cases compared with tuberculous spondylitis (P < 0.05). The occurrence of tuberculous spondylitis cases was predominant in the thoracic region (40.9%) (P < 0.05). Surgical intervention was performed in 54.5% of tuberculous spondylitis and in 24.6% of the pyogenic spondylitis cases (P = 0.009). Conclusion. In Southern Chinese, compared to previous reports over the past 3 decades, a changing prevalence of decreasing tuberculous spondylitis was observed. Pyogenic spondylitis was found to be more common among patients hospitalized for infective spondylitis. This has important implications on the method of diagnosis and the need for establishing microbiological diagnosis before commencing treatment. "Best guess" therapy should not be targeted at tuberculous spondylitis only. There are clear distinctions in the biologic and clinical profiles between tuberculous and pyogenic spondylitis that would help to direct therapy. © 2010, Lippincott Williams & Wilkins.en_HK
dc.languageengen_HK
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_HK
dc.relation.ispartofSpineen_HK
dc.subjectPyogenicen_HK
dc.subjectRisk factorsen_HK
dc.subjectSpineen_HK
dc.subjectSpondylitisen_HK
dc.subjectSymptomsen_HK
dc.subjectTuberculosisen_HK
dc.subjectVertebral osteomyelitisen_HK
dc.titleInfective spondylitis in Southern Chinese: A descriptive and comparative study of ninety-one casesen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0362-2436&volume=35&issue=6&spage=635&epage=641&date=2010&atitle=Infective+spondylitis+in+Southern+Chinese:+a+descriptive+and+comparative+study+of+ninety-one+casesen_HK
dc.identifier.emailSamartzis, D:dspine@hku.hken_HK
dc.identifier.emailLuk, KDK:hcm21000@hku.hken_HK
dc.identifier.emailCheung, KMC:cheungmc@hku.hken_HK
dc.identifier.authoritySamartzis, D=rp01430en_HK
dc.identifier.authorityLuk, KDK=rp00333en_HK
dc.identifier.authorityCheung, KMC=rp00387en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/BRS.0b013e3181cff4f6en_HK
dc.identifier.scopuseid_2-s2.0-78650144633en_HK
dc.identifier.hkuros173068en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-78650144633&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume35en_HK
dc.identifier.issue6en_HK
dc.identifier.spage635en_HK
dc.identifier.epage641en_HK
dc.identifier.isiWOS:000276566800007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYee, DKH=36722933700en_HK
dc.identifier.scopusauthoridSamartzis, D=34572771100en_HK
dc.identifier.scopusauthoridWong, YW=36247941700en_HK
dc.identifier.scopusauthoridLuk, KDK=7201921573en_HK
dc.identifier.scopusauthoridCheung, KMC=7402406754en_HK

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