A Comparison of Demographic and Microorganism Differences Between De Novo and Postoperative Infections.
Publication/Presentation Date
4-8-2026
Abstract
STUDY DESIGN: Retrospective cohort.
OBJECTIVES: To compare demographic and microorganism culture data between primary and postoperative infections.
BACKGROUND: Current literature suggests that both de novo and postoperative infection rates are increasing. At present, there is a paucity of research directly comparing de novo and postoperative spinal infections.
METHODS: Patients aged 18 years or older who underwent an irrigation and debridement (I&D) for de novo spine infections and infections following elective spine surgeries from 2017 to 2023 were compared. All patients were retrospectively reviewed for demographic information, comorbidities, and social history. Tissue microbiology of both cohorts was compared by broad classes (eg, gram-positive vs gram-negative, aerobic vs anaerobic, monomicrobial vs polymicrobial) and individual microbes (eg, Staphylococcus aureus, E. Coli, Pseudomonas, etc). Statistical analysis was performed, and P-value < 0.05 was considered statistically significant.
RESULTS: One hundred fifty-three patients underwent an I&D in the setting of a de novo spine infection, while 239 patients underwent an I&D in the setting of a postoperative infection. Patients who developed de novo infections were on average younger (P = 0.002) with lower BMIs (P < 0.001) and were more likely to be current smokers (P = 0.005). These patients also had higher rates of hepatitis C (P < 0.001), CKD (P = 0.009), and prior IV drug use (P < 0.001). De novo infections had higher rates of gram-positive (P = 0.004), monomicrobial (P = 0.013), and aerobic (P = 0.026) infections than postoperative infections. Staphylococcusaureus infection rates were statistically similar between groups (P = 0.138), while Streptococcus was more common in the postoperative infection cohort (P = 0.002). Pseudomonas, proteus, and Corynebacterium were identified significantly more often in the postoperative infection cohort.
CONCLUSIONS: Patients developing de novo and postoperative spine infections exhibit notable demographic and microorganism differences. Adequate treatment of patients with spinal infections, therefore, requires an awareness of both medical and social factors most prevalent within these two populations.
ISSN
2380-0194
Published In/Presented At
Narayanan, R., Carter, M., Toci, G., Baidya, J., Huang, R., Dalton, J., Syal, A., Von Suskil, M., Mumtaz, S., Kurd, M., Kaye, I. D., Canseco, J., Hilibrand, A., Vaccaro, A., Schroeder, G., & Kepler, C. (2026). A Comparison of Demographic and Microorganism Differences Between De Novo and Postoperative Infections. Clinical spine surgery, 10.1097/BSD.0000000000001951. Advance online publication. https://doi.org/10.1097/BSD.0000000000001951
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
41949405
Department(s)
Administration and Leadership
Document Type
Article