Analysis Of Bacteria Spectrum And Drug Sensitivity Results Of Primary Pyogenic Spondylitis

Background:Primary pyogenic spinal infection is a type of ancient and secretive disease,its common clinical manifestations were fever,lower back pain,but the lack of specific performance,early diagnosis,early treatment there is a big difficulty.The early stage of this type of disease is mainly infringement of the intervertebral disc.As the disease progresses,it may be accompanied by collapse,deformity of the vertebral body,and even paralysis caused by nerve compression.At present,conservative treatment is the first choice for this type of disease,and the formulation of a conservative treatment plan depends on the identification of pathogens.However,there is a certain degree of negative rate in needle biopsy.Therefore,before needle biopsy or when the needle result is negative,it is based on the local epidemic of pathogenic bacteria.The corresponding empirical treatment plan based on the bacteria spectrum and drug sensitivity characteristics is particularly important.Objective:Explore the clinical characteristics of primary pyogenic spinal infection,discuss ways to improve biopsy positive rate of strategy,and analyse the culture-positive cases to get local spectrum of bacteria and characteristics of drug sensitivity.Method:From January 2013 to December 2020,the general data,laboratory indicators,and bacterial culture results of all patients diagnosed with primary pyogenic spinal infection in the first and second areas of the spine in our hospital were statistically analyzed.Result:A total of 80 cases were included in this study,including 49 males and 31 females,aged（59.06±14.343）years old.The lumbar spine was more common in the segment involving the lesion（53/80）,and the main complaint was back pain（72/80）.The positive rate of puncture culture was 68.8%,and the positive rate of culture was not significantly correlated with gender and puncture site（P>0.05）.A total of 21 strains of coagulase-negative staphylococci were cultured,14 strains of Staphylococcus aureus,and 10 strains of Escherichia coli.Compared with the other two types of pathogenic bacteria,patients infected with Staphylococcus aureus are more likely to have hypoproteinemia（P=0.003）,and C-reactive protein and erythrocyte sedimentation rate are also higher（P<0.05）.For levofloxacin and erythromycin,coagulase-negative staphylococci showed stronger resistance,while for rifampicin,Staphylococcus aureus showed stronger resistance（P<0.05）.The resistance rate of penicillin G in coagulase-negative staphylococci has exceeded 75%,the resistance rate of erythromycin has exceeded 50%,and the resistance rate of oxacillin has exceeded 40%.In Staphylococcus aureus,the resistance rate of penicillin G has also exceeded 75%.The resistance rate of cefotaxime in Escherichia coli exceeds 75%,and the resistance rate of cefuroxime,ceftriaxone,ciprofloxacin and levofloxacin is also above 50%.Conclusion:Primary pyogenic spondylitis is more common in the elderly,back pain as the main performance,occur in the lumbar spine.The positive rate of culture has nothing to do with gender and puncture site.The top three pathogenic bacteria in our center are coagulase-negative staphylococcus,staphylococcus aureus and Escherichia coli.Penicillin G,erythromycin and oxacillin are no longer recommended for empirical use in coagulase-negative staphylococcal spondylitis,and penicillin G is no longer suitable for staphylococcal spondylitis,cefotaxime,cefuroxime,Ceftriaxone,ciprofloxacin and levofloxacin are no longer suitable for the empirical medication of Escherichia coli spondylitis.