{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T18:53:59Z","timestamp":1781204039905,"version":"3.54.1"},"reference-count":56,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T00:00:00Z","timestamp":1736467200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy Carol Davila"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Objectives: Spondylodiscitis can be caused by various microorganisms and has shown a continuous rise in incidence and mortality. The purpose of our study was to analyze the demographic and laboratory data, as well as comorbidities of patients that were surgically treated for spondylodiscitis in our hospital. The causative pathogens involved in the etiology of spinal infections were also assessed. Methods: The study included 92 patients who underwent clinical, radiological, and microbiological analyses including bacterial isolation. According to their culture results, patients were divided into three groups: negative results (n = 29), positive results with Mycobacterium tuberculosis (M. tb.) (n = 26), and positive results with other pathological agents (n = 37). Results: Patients with M. tb. had a significantly lower body mass index (p = 0.022) and were significantly younger (p = 0.024) than the others. The analysis of the complete blood work showed significant differences between the groups regarding fibrinogen levels (p = 0.023), C-reactive protein (p = 0.009), and erythrocyte sedimentation rates (p = 0.042). Results also showed significant differences (p = 0.023) for patients with diabetes mellitus who were more prone to a tuberculosis etiology for their spondylodiscitis compared with patients without the disease. Conclusions: These findings have important implications for adopting individualized treatment strategies underlining the need for identification of patients at high risk for specific causative pathogens.<\/jats:p>","DOI":"10.3390\/idr17010006","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T06:25:54Z","timestamp":1736490354000},"page":"6","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Etiological Insights and the Role of Individual Factors in Infectious Spondylodiscitis"],"prefix":"10.3390","volume":"17","author":[{"given":"Diana Elena","family":"Vulpe","sequence":"first","affiliation":[{"name":"Doctoral School, The \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Orthopaedics, \u201cFoisor\u201d Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana-Georgiana","family":"Nedelea","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, \u201cFoisor\u201d Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7403-1684","authenticated-orcid":false,"given":"Serban","family":"Dragosloveanu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, The \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"Department of Orthopaedics, \u201cFoisor\u201d Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2586-4070","authenticated-orcid":false,"given":"Oana","family":"Sandulescu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases I, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania"},{"name":"National Institute for Infectious Diseases \u201cProf. Dr. Matei Bals\u201d, 021105 Bucharest, Romania"},{"name":"Academy of Romanian Scientists, 050044 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7676-6393","authenticated-orcid":false,"given":"Cristian","family":"Scheau","sequence":"additional","affiliation":[{"name":"Department of Physiology, The \u201cCarol Davila\u201d University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania"},{"name":"Department of Radiology and Medical Imaging, \u201cFoisor\u201d Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, 021382 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/idr13010001","article-title":"Acute Brucellosis with a Guillain-Barre Syndrome-Like Presentation: A Case Report and Literature Review","volume":"13","author":"Alanazi","year":"2021","journal-title":"Infect. Dis. Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1007\/s003300050793","article-title":"Spinal infection","volume":"9","author":"Tyrrell","year":"1999","journal-title":"Eur. Radiol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Son, H.J., Kim, M., Kim, D.H., and Kang, C.-N. (2023). Incidence and treatment trends of infectious spondylodiscitis in South Korea: A nationwide population-based study. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0287846"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2695","DOI":"10.1097\/01.brs.0000244662.78725.37","article-title":"Nontuberculous pyogenic spinal infection in adults: A 12-year experience from a tertiary referral center","volume":"31","author":"Butler","year":"2006","journal-title":"Spine"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1007\/s00113-006-1084-7","article-title":"Surgical management of spondylodiscitis: An analysis of 78 cases","volume":"109","author":"Frangen","year":"2006","journal-title":"Der Unfallchirurg"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"513","DOI":"10.3109\/17453679808997789","article-title":"Epidemiology of acute vertebral osteomyelitis in Denmark: 137 cases in Denmark 1978\u20131982, compared to cases reported to the National Patient Register 1991\u20131993","volume":"69","author":"Krogsgaard","year":"1998","journal-title":"Acta Orthop. Scand."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1177\/230949901202000103","article-title":"Pyogenic discitis following discectomy","volume":"20","author":"Moon","year":"2012","journal-title":"J. Orthop. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Nedelea, D.G., Vulpe, D., Enyedi, M., Cergan, R., Scheau, C., Baz, R.O., and Dragosloveanu, S. (2024). Comprehensive Approach of the Diagnosis, Treatment, and Medical Rehabilitation of Patients with Spondylolisthesis. Balneo PRM Res. J., 15.","DOI":"10.12680\/balneo.2024.709"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"283","DOI":"10.3171\/2021.12.SPINE21811","article-title":"Risk factors for surgical intervention in patients with primary spinal infection on initial presentation","volume":"37","author":"Jin","year":"2022","journal-title":"J. Neurosurg. Spine"},{"key":"ref_10","first-page":"2","article-title":"Epidemiological and clinical features of pyogenic spondylodiscitis","volume":"16","author":"Fantoni","year":"2012","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"874","DOI":"10.2106\/00004623-199706000-00011","article-title":"Pyogenic vertebral osteomyelitis","volume":"79","author":"Carragee","year":"1997","journal-title":"J. Bone Jt. Surg."},{"key":"ref_12","first-page":"63","article-title":"Spinal Epidural Abscess Presented with Sciatica: A Case Report","volume":"62","author":"Chansuchai","year":"2018","journal-title":"Vajira Med. J. J. Urban Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2787","DOI":"10.1007\/s00586-013-2850-1","article-title":"Spinal infection: State of the art and management algorithm","volume":"22","author":"Duarte","year":"2013","journal-title":"Eur. Spine J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/PL00011954","article-title":"Spinal epidural abscess: A meta-analysis of 915 patients","volume":"23","author":"Reihsaus","year":"2000","journal-title":"Neurosurg. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"717","DOI":"10.3390\/idr15060064","article-title":"Perioperative Urinary Catheter Use and Association to (Gram-Negative) Surgical Site Infection after Spine Surgery","volume":"15","author":"Ansorge","year":"2023","journal-title":"Infect. Dis. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.mric.2023.12.003","article-title":"Bacterial and Viral Infectious Disease of the Spine","volume":"32","author":"Wangaryattawanich","year":"2024","journal-title":"Magn. Reson. Imaging Clin. N. Am."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.12968\/hmed.2023.0063","article-title":"The adult with low back pain: Causes, diagnosis, imaging features and management","volume":"84","author":"Kabeer","year":"2023","journal-title":"Br. J. Hosp. Med."},{"key":"ref_18","first-page":"e60065","article-title":"Beyond the Bony Fragment: A Review of Limbus Vertebra","volume":"16","author":"Niscoveanu","year":"2024","journal-title":"Cureus J. Med. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1053\/j.semnuclmed.2022.11.005","article-title":"Imaging of Spondylodiscitis: An Update","volume":"53","author":"Raghavan","year":"2023","journal-title":"Semin. Nucl. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"740","DOI":"10.18019\/1028-4427-2021-27-6-740-745","article-title":"Comparison of the main risk factors for sepsis in patients with non-specific osteomyelitis of the spine and tuberculous spondylitis","volume":"27","author":"Vishnevskii","year":"2021","journal-title":"Genij Ortopedii"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1093\/jac\/dkq303","article-title":"Spondylodiscitis: Update on diagnosis and management","volume":"65","author":"Gouliouris","year":"2010","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Sheikh, A.F., Khosravi, A.D., Goodarzi, H., Nashibi, R., Teimouri, A., Motamedfar, A., Ranjbar, R., Afzalzadeh, S., Cyrus, M., and Hashemzadeh, M. (2017). Pathogen identification in suspected cases of pyogenic spondylodiscitis. Front. Cell. Infect. Microbiol., 7.","DOI":"10.3389\/fcimb.2017.00060"},{"key":"ref_23","first-page":"117","article-title":"A systematic review: Characteristics, complications and treatment of spondylodiscitis","volume":"23","author":"Gentile","year":"2019","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"83","DOI":"10.2739\/kurumemedj.MS653001","article-title":"Pyogenic spondylitis: Clinical features, diagnosis and treatment","volume":"65","author":"Sato","year":"2018","journal-title":"Kurume Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1515\/folmed-2017-0024","article-title":"Spontaneous spondylodiscitis-epidemiology, clinical features, diagnosis and treatment","volume":"59","author":"Petkova","year":"2017","journal-title":"Folia Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1086\/340102","article-title":"Vertebral osteomyelitis: Long-term outcome for 253 patients from 7 Cleveland-area hospitals","volume":"34","author":"McHenry","year":"2002","journal-title":"Clin. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1038\/sc.1969.30","article-title":"The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia","volume":"7","author":"Frankel","year":"1969","journal-title":"Spinal Cord"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"7310","DOI":"10.4081\/idr.2018.7310","article-title":"Meningitis, spondylodiscitis, pneumonia and septic shock with Streptococcus pneumoniae in a previously healthy woman with isolated IgG2-, IgG3-, IgA-deficiency and monoclonal gammopathy of undetermined significance","volume":"10","author":"Gaini","year":"2018","journal-title":"Infect. Dis. Rep."},{"key":"ref_29","unstructured":"The European Committee on Antimicrobial Susceptibility Testing (2024, January 01). Breakpoint Tables for Interpretation of MICs and Zone Diameters; version 14.0. Available online: http:\/\/www.eucast.org."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.1016\/j.spinee.2021.06.019","article-title":"Long-term quality of life outcome after spondylodiscitis treatment","volume":"21","author":"Stoop","year":"2021","journal-title":"Spine J."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s00264-011-1445-x","article-title":"Management of infectious discitis. Outcome in one hundred and eight patients in a university hospital","volume":"36","author":"Agreda","year":"2012","journal-title":"Int. Orthop."},{"key":"ref_32","first-page":"39","article-title":"Architectural design strategies for infection prevention and control in resource-limited rural healthcare facilities in developing countries: Bridging the gap with context-sensitive design","volume":"6","author":"Ceccarelli","year":"2024","journal-title":"UniCamillus Glob. Health J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.3390\/idr16050080","article-title":"Progressive Thoracolumbar Tuberculosis in a Young Male: Diagnostic, Therapeutic, and Surgical Insights","volume":"16","author":"Nedelea","year":"2024","journal-title":"Infect. Dis. Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.2147\/RMHP.S458722","article-title":"Active Case-Finding: An Effective Solution for Tuberculosis Detection in Vulnerable Groups\u2013The Romanian Experience","volume":"17","author":"Mahler","year":"2024","journal-title":"Risk Manag. Healthc. Policy"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"6568","DOI":"10.4081\/idr.2016.6568","article-title":"Tuberculosis Biomarkers: From Diagnosis to Protection","volume":"8","author":"Goletti","year":"2016","journal-title":"Infect. Dis. Rep."},{"key":"ref_36","first-page":"58","article-title":"Tuberculous spondylodiscitis: Epidemiology, clinical features, treatment, and outcome","volume":"16","author":"Trecarichi","year":"2012","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"107002","DOI":"10.1016\/j.ijid.2024.107002","article-title":"Screening for latent tuberculosis in migrants-status quo and future challenges","volume":"141","author":"Petersen","year":"2024","journal-title":"Int. J. Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"624","DOI":"10.5588\/ijtld.16.0845","article-title":"Tuberculosis in migrants in low-incidence countries: Epidemiology and intervention entry points","volume":"21","author":"Mor","year":"2017","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1007\/BF01301428","article-title":"Primary stable anterior instrumentation or dorsoventral spondylodesis in spondylodiscitis? Results of a comparative study","volume":"6","author":"Eysel","year":"1997","journal-title":"Eur. Spine J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jinf.2008.02.005","article-title":"Infectious spondylodiscitis","volume":"56","author":"Cottle","year":"2008","journal-title":"J. Infect."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"4664","DOI":"10.1007\/s00586-024-08433-0","article-title":"A diagnostic model for differentiating tuberculous spondylodiscitis from pyogenic spondylodiscitis based on pathogen-confirmed patients","volume":"33","author":"Zhang","year":"2024","journal-title":"Eur. Spine J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/j.semarthrit.2004.08.004","article-title":"Comparative study of postoperative and spontaneous pyogenic spondylodiscitis","volume":"34","author":"Dufour","year":"2005","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s00264-011-1384-6","article-title":"Pyogenic spondylitis","volume":"36","author":"Cheung","year":"2012","journal-title":"Int. Orthop."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.semarthrit.2007.08.007","article-title":"Long-term clinical and radiological magnetic resonance imaging outcome of abscess-associated spontaneous pyogenic vertebral osteomyelitis under conservative management","volume":"38","author":"Euba","year":"2008","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_45","first-page":"181","article-title":"Current diagnosis and treatment of spondylodiscitis","volume":"105","author":"Sobottke","year":"2008","journal-title":"Dtsch. \u00c4rzteblatt Int."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.1007\/s00586-012-2614-3","article-title":"Failure modes in conservative and surgical management of infectious spondylodiscitis","volume":"22","author":"Valancius","year":"2013","journal-title":"Eur. Spine J."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Loft, J.A., M\u00f8ller, D.L., Thudium, R.F., Knudsen, J.D., Ostrowski, S.R., Andersen, \u00c5.B., and Nielsen, S.D. (2022). The induced immune response in patients with infectious spondylodiscitis: A prospective observational cohort study. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.858934"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2201","DOI":"10.1177\/21925682221077918","article-title":"Preoperative risk factors affecting outcome in surgically treated pyogenic spondylodiscitis","volume":"13","author":"Ukon","year":"2023","journal-title":"Glob. Spine J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1017\/S0950268818002480","article-title":"The updated Charlson comorbidity index is a useful predictor of mortality in patients with Staphylococcus aureus bacteraemia","volume":"146","author":"Ragozzino","year":"2018","journal-title":"Epidemiol. Infect."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e101","DOI":"10.2106\/JBJS.J.01935","article-title":"Obesity, diabetes, and preoperative hyperglycemia as predictors of periprosthetic joint infection: A single-center analysis of 7181 primary hip and knee replacements for osteoarthritis","volume":"94","author":"Nevalainen","year":"2012","journal-title":"J. Bone Jt. Surg."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Savulescu-Fiedler, I., Mihalcea, R., Dragosloveanu, S., Scheau, C., Baz, R.O., Caruntu, A., Scheau, A.-E., Caruntu, C., and Benea, S.N. (2024). The interplay between obesity and inflammation. Life, 14.","DOI":"10.3390\/life14070856"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Schoof, B., Stangenberg, M., Mende, K.C., Thiesen, D.M., Ntalos, D., and Dreimann, M. (2020). Obesity in spontaneous spondylodiscitis: A relevant risk factor for severe disease courses. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-79012-8"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"77","DOI":"10.18683\/germs.2024.1419","article-title":"Implications of using artificial intelligence in the diagnosis of sepsis\/sepsis shock","volume":"14","author":"Gorecki","year":"2024","journal-title":"GERMS"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2206","DOI":"10.1001\/archinte.164.20.2206","article-title":"Cigarette smoking and infection","volume":"164","author":"Arcavi","year":"2004","journal-title":"Arch. Intern. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s43166-021-00076-z","article-title":"Relationship between smoking, clinical, inflammatory, and radiographic parameters in patients with ankylosing spondylitis","volume":"48","author":"Farouk","year":"2021","journal-title":"Egypt. Rheumatol. Rehabil."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1017\/ice.2015.221","article-title":"The protective role of albumin in Clostridium difficile infection: A step toward solving the puzzle","volume":"36","author":"Turla","year":"2015","journal-title":"Infect. Control. Hosp. Epidemiol."}],"container-title":["Infectious Disease Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7449\/17\/1\/6\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:26:26Z","timestamp":1759919186000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7449\/17\/1\/6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,10]]},"references-count":56,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["idr17010006"],"URL":"https:\/\/doi.org\/10.3390\/idr17010006","relation":{},"ISSN":["2036-7449"],"issn-type":[{"value":"2036-7449","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,10]]}}}