{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:23:32Z","timestamp":1777659812478,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2025,4]]},"abstract":"\n Study Design<\/jats:title>\n Prognostic study.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n The objective of this study is to identify predictive factors for cloxacillin susceptibility in spinal infections.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective analysis was conducted using data from January 1, 1997, to December 31, 2021. The study included patients presenting with back pain and either a positive bacterial culture from the spine or radiological evidence of spinal infection (spondylodiscitis and\/or epidural abscess) along with positive bacterial blood culture.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 171 patients (127 males, 44 females), 53.2% had\n Staphylococcus<\/jats:italic>\n isolates, with 40.4% showing cloxacillin resistance. Lower globulin levels (<33.5\u00a0g\/L), recent hospitalization within 90\u00a0days, and residence in an old age home predicted gram-positive bacteria with cloxacillin resistance and gram-negative bacteria as causative organisms (\n P<\/jats:italic>\n <.05). The 30-day and 1-year all-cause mortality rates were 0% and 8.2%, respectively. Higher red cell distribution width (RDW >16.1%) and Charlson comorbidity index (CCI) scores predicted 1-year all-cause mortality (\n P<\/jats:italic>\n <.05). Intensive care unit admission was required for 9.9% of patients.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study identified predictive factors for spinal infection by gram-positive bacteria with cloxacillin resistance and gram-negative bacteria. Patients with lower globulin levels (<33.5\u00a0g\/L), recent hospitalization within 90\u00a0days, or residency in an old age home upon admission should avoid standalone cloxacillin therapy and consider antibiotics with gram-negative coverage. Higher RDW (>16.1%) and CCI scores were associated with increased 1-year all-cause mortality. These findings contribute to treatment decision-making and improving patient outcomes in spinal infections.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/21925682241251814","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T17:45:39Z","timestamp":1715017539000},"page":"1572-1581","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictive Factors of Cloxacillin Susceptibility in Primary Bacterial Spinal Infection"],"prefix":"10.1177","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9854-8917","authenticated-orcid":false,"given":"Chris Yuk Kwan","family":"Tang","sequence":"first","affiliation":[{"name":"The University of Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pak Leung","family":"Ho","sequence":"additional","affiliation":[{"name":"University of Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,5,6]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-013-2850-1"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2739\/kurumemedj.MS653001"},{"issue":"12","key":"e_1_3_3_4_2","first-page":"1743","article-title":"Misdiagnosis in vertebral osteomyelitis: problems and factors","volume":"84","author":"Buranapanitkit B","year":"2001","unstructured":"Buranapanitkit B, Lim A, Geater A. Misdiagnosis in vertebral osteomyelitis: problems and factors. J Med Assoc Thai. 2001;84(12):1743-1750.","journal-title":"J Med Assoc Thai"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-13-00102"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2013.07.026"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ482"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"issue":"2","key":"e_1_3_3_9_2","first-page":"117","article-title":"A systematic review: characteristics, complications and treatment of spondylodiscitis","volume":"23","author":"Gentile L","year":"2019","unstructured":"Gentile L, Benazzo F, De Rosa F, et al. A systematic review: characteristics, complications and treatment of spondylodiscitis. Eur Rev Med Pharmacol Sci. 2019;23(2 Suppl):117-128.","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"2","key":"e_1_3_3_10_2","first-page":"2","article-title":"Epidemiological and clinical features of pyogenic spondylodiscitis","volume":"16","author":"Fantoni M","year":"2012","unstructured":"Fantoni M, Trecarichi EM, Rossi B, et al. Epidemiological and clinical features of pyogenic spondylodiscitis. Eur Rev Med Pharmacol Sci. 2012;16 Suppl 2(Suppl 2):2-7.","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_3_3_11_2","volume-title":"Clinical Methods: The History, Physical, and Laboratory Examinations","author":"Jt B","year":"1990","unstructured":"Jt B. Serum albumin and globulin. In: HK W, WD H, JW H, eds. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Boston: Butterworths; 1990.","edition":"3"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-020-01959-1"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2018-000025"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-27688-z"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.616793"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.11.182"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23982"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.55"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.22058"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1197\/j.aem.2005.11.084"}],"container-title":["Global Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682241251814","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21925682241251814","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21925682241251814","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:20:40Z","timestamp":1777447240000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21925682241251814"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,6]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1177\/21925682241251814"],"URL":"https:\/\/doi.org\/10.1177\/21925682241251814","relation":{},"ISSN":["2192-5682","2192-5690"],"issn-type":[{"value":"2192-5682","type":"print"},{"value":"2192-5690","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,6]]}}}