Antibiotics (Mar 2023)

<i>Cutibacterium</i> spp. Infections after Instrumented Spine Surgery Have a Good Prognosis Regardless of Rifampin Use: A Cross-Sectional Study

  • Susana Núñez-Pereira,
  • Eva Benavent,
  • Marta Ulldemolins,
  • Beatriz Sobrino-Díaz,
  • José A. Iribarren,
  • Rosa Escudero-Sánchez,
  • María Dolores Del Toro,
  • Andrés Nodar,
  • Luisa Sorli,
  • Alberto Bahamonde,
  • Helem H. Vilchez,
  • Oriol Gasch,
  • Elena Muñez,
  • David Rodríguez-Montserrat,
  • María José García-País,
  • Sleiman Haddad,
  • Julia Sellarès-Nadal,
  • Oscar Murillo,
  • Dolors Rodríguez-Pardo,
  • on behalf of GEIO–SEIMC (Group for the Study of Osteoarticular Infections–Spanish Society of Infectious Diseases and Clinical Microbiology)

DOI
https://doi.org/10.3390/antibiotics12030518
Journal volume & issue
Vol. 12, no. 3
p. 518

Abstract

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Infection after spinal instrumentation (IASI) by Cutibacterium spp. is being more frequently reported. The aim of this study was to analyse the incidence, risk factors, clinical characteristics, and outcome of a Cutibacterium spp. IASI (CG) compared with non-Cutibacterium IASI (NCG) infections, with an additional focus on the role of rifampin in the treatment. All patients from a multicentre, retrospective, observational study with a confirmed IASI between January 2010 and December 2016 were divided into two groups: (CG and NCG) IASI. Baseline, medical, surgical, infection treatment, and follow-up data were compared for both groups. In total, 411 patients were included: 27 CG and 384 NCG. The CG patients were significantly younger. They had a longer median time to diagnosis (23 vs. 13 days) (p = 0.025), although 55.6% debuted within the first month after surgery. Cutibacterium patients were more likely to have the implant removed (29.6% vs. 12.8%; p = 0.014) and received shorter antibiotic regimens (p = 0.014). In 33% of Cutibacterium cases, rifampin was added to the baseline therapy. None of the 27 infections resulted in treatment failure during follow-up regardless of rifampin use. Cutibacterium spp. is associated with a younger age and may cause both early and late IASIs. In our experience, the use of rifampin to improve the outcome in the treatment of a Cutibacterium spp. IASI is not relevant since, in our series, none of the cases had therapeutic failure regardless of the use of rifampin.

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