Bacteria detected after instrumentation surgery for pyogenic vertebral osteomyelitis in a canine model.

Abstract

OBJECTIVE:

This study was designed to identify the presence, type and origin of bacteria adjacent to the metal implant in the infected region in a canine model of pyogenic vertebral osteomyelitis treated with single-stage anterior autogenous bone grafting and instrumentation.

METHODS:

Dogs with pyogenic spondylodiscitis underwent one-stage debridement, autogenous bone grafting and titanium plate instrumentation and perioperative antibiotic therapy. The implants and adjacent vertebral bones were removed surgically at various postoperative time points (4, 8, 12 and 24 weeks) for bacteria detection. Bacteria were detected from retrieved spinal implants as well as surrounding bones by culture and/or pyrosequencing methods in 17 (85%) of all 20 animals. The positive rate for bacteria presence was 45% by culture and 80% by pyrosequencing method.

RESULTS:

Radiological or macroscopic examination showed no signs for infection recurrence in any animal regardless of bacteria presence at the surgical site. However, organism identical with the causative bacterium for spinal infection was found in only two of nine culture-positive animals.

CONCLUSION:

Within the confines of the study, the use of metallic implants in an infected area did not lead to a clinically relevant infection although bacteria may exist at the surgical site. The use of metallic implants in an infected area of the spine is safe. The metallic implants may not be the “culprit” for the persistence or recurrence of infection.

• Authors: Wei-Hua Chen, Yi-Jun Kang, Li-Yang Dai, Bing Wang, Chang Lu, Jing Li, Guo-Hua Lü
• Journal: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (Eur Spine J) Vol. 23 Issue 4 Pg. 838-45 (Apr 2014) ISSN: 1432-0932 [Electronic] Germany
• PMID: 24121752 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Titanium

Topics

• Animals
• Bone Plates (microbiology)
• Bone Transplantation (methods)
• Debridement (methods)
• Discitis (microbiology, surgery)
• Disease Models, Animal
• Dogs
• Escherichia coli (isolation & purification)
• Male
• Osteomyelitis (microbiology, surgery)
• Recurrence
• Spinal Fusion (instrumentation, methods)
• Staphylococcal Infections (microbiology, surgery)
• Staphylococcus aureus (isolation & purification)
• Staphylococcus haemolyticus (isolation & purification)
• Streptococcus agalactiae (isolation & purification)
• Titanium
• Transplantation, Autologous