The incidence of Pyogenic
Spondylodiscitis (PS) seems to be increasing in the last years as a result of
the higher life expectancy of older patients with chronic debilitating
diseases; also a number of co-morbidities have been found to increase the risk
of disease such as diabetes (11-31%), immunosuppression, intravenous drug use,
alcoholism, chronic debility disease with decubitus ulcers, malignancy, alcohol
use and renal failure.
The source of infection in the
elderly has been related to the use of intravenous access devices and the
asymptomatic urinary infections.A single organism is usually involved, although
polymicrobial
infections do occur in chronic and debility conditions. Staphylococcus
aureus is the most common organism isolated implicated into 15- 84% of
nontuberculosis cases of infection and frequently observed as complication of
invasive spinal procedures (17-33%).
Bacilli gramnegative such as
E.Coli, Proteus and Pseudomonas are often associated with immunosuppressive
conditions, diabetes, procedures or infection involving the genitourinary and
gastrointestinal tract. At the other hand immuno compromise patients, homeless,
alcolists, prisoners or immigrants from sub-Saharan Africa, the Indian
sub-continent and south-east Asia are exposed to tuberculosis infection.
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