The identification of low-pathogenic bacteria on removed spinal implants and implications for antimicrobial prophylaxis
Introduction: The role of low-pathogenic bacteria cultured from removed spinal implants is unclear and the efficacy of perioperative single-dose antibiotics against such bacteria remains underexplored. Research question: This study aims to investigate whether pedicle screw loosening is associated wi...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Brain and Spine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529424014085 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850105526688415744 |
|---|---|
| author | Ann-Kathrin Joerger Vicki M. Butenschoen Susanne Feihl Sebastian Rühling Jan S. Kirschke Bernhard Meyer Sandro M. Krieg |
| author_facet | Ann-Kathrin Joerger Vicki M. Butenschoen Susanne Feihl Sebastian Rühling Jan S. Kirschke Bernhard Meyer Sandro M. Krieg |
| author_sort | Ann-Kathrin Joerger |
| collection | DOAJ |
| description | Introduction: The role of low-pathogenic bacteria cultured from removed spinal implants is unclear and the efficacy of perioperative single-dose antibiotics against such bacteria remains underexplored. Research question: This study aims to investigate whether pedicle screw loosening is associated with pathogens and if the choice of perioperative antibiotics can prevent these bacteria. Methods: A retrospective analysis was conducted on 93 patients with implants removed between 01/01/2018 and 03/31/2020. Patients with both loosened and non-loosened implants were included. The latter group was subdivided into cases where implants were exchanged due to adjacent segment degeneration (ASD) and those with elective implant removal after fracture healing. Bacterial cultures from removed implants were analyzed for resistance profiles against the prophylactic single-shot antibiotics administered during implantation. Patients with acute infection, spondylodiscitis, deep wound infection, empyema, and carbon/polyetheretherketone spinal implants were excluded. Results: Bacterial isolates were detected in both loosened (41%) and non-loosened (27%) implants (p = 0.23). The most frequently cultivated bacteria were Cutibacterium acnes and Staphylococcus epidermidis. Sensitivity to the administered antibiotics was 75%. While Cutibacterium acnes was entirely sensitive, Staphylococcus epidermidis was completely resistant. Patients with loosened implants without bacteria had a significantly lower bone mineral density (BMD) than patients with implants removed due to ASD. However, patients with loosened implants and positive bacterial cultures had comparable BMD to ASD patients. Conclusions: The high rate of sensitive Cutibacterium acnes and resistant Staphylococcus epidermidis on removed spinal implants suggests a need to revisit current antimicrobial prophylaxis. Further research is required to determine the clinical significance of low-virulence bacteria, especially on non-loosened implants. |
| format | Article |
| id | doaj-art-fe914846a4c14d4fbdbd677d8c07dc3a |
| institution | OA Journals |
| issn | 2772-5294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj-art-fe914846a4c14d4fbdbd677d8c07dc3a2025-08-20T02:39:03ZengElsevierBrain and Spine2772-52942025-01-01510415210.1016/j.bas.2024.104152The identification of low-pathogenic bacteria on removed spinal implants and implications for antimicrobial prophylaxisAnn-Kathrin Joerger0Vicki M. Butenschoen1Susanne Feihl2Sebastian Rühling3Jan S. Kirschke4Bernhard Meyer5Sandro M. Krieg6Department of Neurosurgery, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany; Corresponding author.Department of Neurosurgery, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, GermanyInstitute for Medical Microbiology, Immunology and Hygiene, Technical University of Munich, Trogerstr. 30, 81675, Munich, GermanyDepartment of Neuroradiology, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, GermanyDepartment of Neuroradiology, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, GermanyDepartment of Neurosurgery, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, GermanyDepartment of Neurosurgery, Ruprecht-Karls-University Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, GermanyIntroduction: The role of low-pathogenic bacteria cultured from removed spinal implants is unclear and the efficacy of perioperative single-dose antibiotics against such bacteria remains underexplored. Research question: This study aims to investigate whether pedicle screw loosening is associated with pathogens and if the choice of perioperative antibiotics can prevent these bacteria. Methods: A retrospective analysis was conducted on 93 patients with implants removed between 01/01/2018 and 03/31/2020. Patients with both loosened and non-loosened implants were included. The latter group was subdivided into cases where implants were exchanged due to adjacent segment degeneration (ASD) and those with elective implant removal after fracture healing. Bacterial cultures from removed implants were analyzed for resistance profiles against the prophylactic single-shot antibiotics administered during implantation. Patients with acute infection, spondylodiscitis, deep wound infection, empyema, and carbon/polyetheretherketone spinal implants were excluded. Results: Bacterial isolates were detected in both loosened (41%) and non-loosened (27%) implants (p = 0.23). The most frequently cultivated bacteria were Cutibacterium acnes and Staphylococcus epidermidis. Sensitivity to the administered antibiotics was 75%. While Cutibacterium acnes was entirely sensitive, Staphylococcus epidermidis was completely resistant. Patients with loosened implants without bacteria had a significantly lower bone mineral density (BMD) than patients with implants removed due to ASD. However, patients with loosened implants and positive bacterial cultures had comparable BMD to ASD patients. Conclusions: The high rate of sensitive Cutibacterium acnes and resistant Staphylococcus epidermidis on removed spinal implants suggests a need to revisit current antimicrobial prophylaxis. Further research is required to determine the clinical significance of low-virulence bacteria, especially on non-loosened implants.http://www.sciencedirect.com/science/article/pii/S2772529424014085Low-grade infectionPedicle screw looseningLow-pathogenic bacteria |
| spellingShingle | Ann-Kathrin Joerger Vicki M. Butenschoen Susanne Feihl Sebastian Rühling Jan S. Kirschke Bernhard Meyer Sandro M. Krieg The identification of low-pathogenic bacteria on removed spinal implants and implications for antimicrobial prophylaxis Brain and Spine Low-grade infection Pedicle screw loosening Low-pathogenic bacteria |
| title | The identification of low-pathogenic bacteria on removed spinal implants and implications for antimicrobial prophylaxis |
| title_full | The identification of low-pathogenic bacteria on removed spinal implants and implications for antimicrobial prophylaxis |
| title_fullStr | The identification of low-pathogenic bacteria on removed spinal implants and implications for antimicrobial prophylaxis |
| title_full_unstemmed | The identification of low-pathogenic bacteria on removed spinal implants and implications for antimicrobial prophylaxis |
| title_short | The identification of low-pathogenic bacteria on removed spinal implants and implications for antimicrobial prophylaxis |
| title_sort | identification of low pathogenic bacteria on removed spinal implants and implications for antimicrobial prophylaxis |
| topic | Low-grade infection Pedicle screw loosening Low-pathogenic bacteria |
| url | http://www.sciencedirect.com/science/article/pii/S2772529424014085 |
| work_keys_str_mv | AT annkathrinjoerger theidentificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis AT vickimbutenschoen theidentificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis AT susannefeihl theidentificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis AT sebastianruhling theidentificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis AT janskirschke theidentificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis AT bernhardmeyer theidentificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis AT sandromkrieg theidentificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis AT annkathrinjoerger identificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis AT vickimbutenschoen identificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis AT susannefeihl identificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis AT sebastianruhling identificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis AT janskirschke identificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis AT bernhardmeyer identificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis AT sandromkrieg identificationoflowpathogenicbacteriaonremovedspinalimplantsandimplicationsforantimicrobialprophylaxis |