Chronic dialysis patients with infectious spondylodiscitis have poorer outcomes than non-dialysis populations

George Kuo,1 Wei-Chiao Sun,1 Yueh-An Lu,1 Chao-Yu Chen,1 Huang-Kai Kao,2 YuJr Lin,3 Yung-Chang Chen,4 Cheng-Chieh Hung,1 Ya-Chung Tian,1 Hsiang-Hao Hsu1 1Department of Nephrology, Kidney Research Center, College of Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwa...

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Autores principales:	Kuo G, Sun WC, Lu YA, Chen CY, Kao HK, Lin Y, Chen YC, Hung CC, Tian YC, Hsu HH
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	End stage renal disease pyogenic spondylodiscitis Methicillin-resistant Staphylococcus aureus Mortality Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/d49a11fc265d4c5e844d7f52191e3a53
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spelling	oai:doaj.org-article:d49a11fc265d4c5e844d7f52191e3a532021-12-02T12:27:32ZChronic dialysis patients with infectious spondylodiscitis have poorer outcomes than non-dialysis populations1178-203Xhttps://doaj.org/article/d49a11fc265d4c5e844d7f52191e3a532018-02-01T00:00:00Zhttps://www.dovepress.com/chronic-dialysis-patients-with-infectious-spondylodiscitis-have-poorer-peer-reviewed-article-TCRMhttps://doaj.org/toc/1178-203XGeorge Kuo,1 Wei-Chiao Sun,1 Yueh-An Lu,1 Chao-Yu Chen,1 Huang-Kai Kao,2 YuJr Lin,3 Yung-Chang Chen,4 Cheng-Chieh Hung,1 Ya-Chung Tian,1 Hsiang-Hao Hsu1 1Department of Nephrology, Kidney Research Center, College of Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan; 2Department of Plastic and Reconstructive Surgery, College of Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan; 3Center for Big Data Analytics and Statistics, College of Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan; 4Department of Internal Medicine, Division of Nephrology, College of Medicine, Keelung Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan Purpose: Infectious spondylodiscitis is a serious disease that can lead to permanent neurological deficit. Because there were only a few case reports or series featuring infectious spondylodiscitis in chronic dialysis patients, we investigated the epidemiology and outcome in the chronic dialysis patients versus general population.Materials and methods: We retrospectively identified chronic dialysis patients admitted for infectious spondylodiscitis between January 2002 and December 2015. A total of 105 chronic dialysis patients were included, and we performed a 1:2 case–control match on propensity score in non-dialysis patients with infectious spondylodiscitis. The demographic features, clinical manifestation, infection focus, and disease outcome were recorded.Results: A total of 302 patients entered the final analysis. Chronic dialysis patients less frequently had fever (34.3%), and in the majority, bacterial entry was through dialysis vascular access (30.5%). Methicillin-resistant Staphylococcus aureus (MRSA) comprised the majority of causative pathogen. The chronic dialysis group had longer hospital stay, higher in-hospital mortality, and higher 1-year mortality. The odds ratio of in-hospital mortality was 2.20 compared with the non-dialysis group.Conclusions: The study highlighted poorer outcome and high frequency of resistant Staphylococcus of infectious spondylodiscitis in chronic dialysis patients. Therefore, high vigilance, prompt recognition, and empiric coverage of MRSA will be important in the management of infectious spondylodiscitis in chronic dialysis patients. Keywords: end stage renal disease, pyogenic spondylodiscitis, infectious spondylodiscitis, methicillin-resistant Staphylococcus aureus, mortalityKuo GSun WCLu YAChen CYKao HKLin YChen YCHung CCTian YCHsu HHDove Medical PressarticleEnd stage renal diseasepyogenic spondylodiscitisMethicillin-resistant Staphylococcus aureusMortalityTherapeutics. PharmacologyRM1-950ENTherapeutics and Clinical Risk Management, Vol Volume 14, Pp 257-263 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	End stage renal disease pyogenic spondylodiscitis Methicillin-resistant Staphylococcus aureus Mortality Therapeutics. Pharmacology RM1-950
spellingShingle	End stage renal disease pyogenic spondylodiscitis Methicillin-resistant Staphylococcus aureus Mortality Therapeutics. Pharmacology RM1-950 Kuo G Sun WC Lu YA Chen CY Kao HK Lin Y Chen YC Hung CC Tian YC Hsu HH Chronic dialysis patients with infectious spondylodiscitis have poorer outcomes than non-dialysis populations
description	George Kuo,1 Wei-Chiao Sun,1 Yueh-An Lu,1 Chao-Yu Chen,1 Huang-Kai Kao,2 YuJr Lin,3 Yung-Chang Chen,4 Cheng-Chieh Hung,1 Ya-Chung Tian,1 Hsiang-Hao Hsu1 1Department of Nephrology, Kidney Research Center, College of Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan; 2Department of Plastic and Reconstructive Surgery, College of Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan; 3Center for Big Data Analytics and Statistics, College of Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan; 4Department of Internal Medicine, Division of Nephrology, College of Medicine, Keelung Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan Purpose: Infectious spondylodiscitis is a serious disease that can lead to permanent neurological deficit. Because there were only a few case reports or series featuring infectious spondylodiscitis in chronic dialysis patients, we investigated the epidemiology and outcome in the chronic dialysis patients versus general population.Materials and methods: We retrospectively identified chronic dialysis patients admitted for infectious spondylodiscitis between January 2002 and December 2015. A total of 105 chronic dialysis patients were included, and we performed a 1:2 case–control match on propensity score in non-dialysis patients with infectious spondylodiscitis. The demographic features, clinical manifestation, infection focus, and disease outcome were recorded.Results: A total of 302 patients entered the final analysis. Chronic dialysis patients less frequently had fever (34.3%), and in the majority, bacterial entry was through dialysis vascular access (30.5%). Methicillin-resistant Staphylococcus aureus (MRSA) comprised the majority of causative pathogen. The chronic dialysis group had longer hospital stay, higher in-hospital mortality, and higher 1-year mortality. The odds ratio of in-hospital mortality was 2.20 compared with the non-dialysis group.Conclusions: The study highlighted poorer outcome and high frequency of resistant Staphylococcus of infectious spondylodiscitis in chronic dialysis patients. Therefore, high vigilance, prompt recognition, and empiric coverage of MRSA will be important in the management of infectious spondylodiscitis in chronic dialysis patients. Keywords: end stage renal disease, pyogenic spondylodiscitis, infectious spondylodiscitis, methicillin-resistant Staphylococcus aureus, mortality
format	article
author	Kuo G Sun WC Lu YA Chen CY Kao HK Lin Y Chen YC Hung CC Tian YC Hsu HH
author_facet	Kuo G Sun WC Lu YA Chen CY Kao HK Lin Y Chen YC Hung CC Tian YC Hsu HH
author_sort	Kuo G
title	Chronic dialysis patients with infectious spondylodiscitis have poorer outcomes than non-dialysis populations
title_short	Chronic dialysis patients with infectious spondylodiscitis have poorer outcomes than non-dialysis populations
title_full	Chronic dialysis patients with infectious spondylodiscitis have poorer outcomes than non-dialysis populations
title_fullStr	Chronic dialysis patients with infectious spondylodiscitis have poorer outcomes than non-dialysis populations
title_full_unstemmed	Chronic dialysis patients with infectious spondylodiscitis have poorer outcomes than non-dialysis populations
title_sort	chronic dialysis patients with infectious spondylodiscitis have poorer outcomes than non-dialysis populations
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/d49a11fc265d4c5e844d7f52191e3a53
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Chronic dialysis patients with infectious spondylodiscitis have poorer outcomes than non-dialysis populations

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