Korean J Neurotrauma.  2019 Oct;15(2):143-149. 10.13004/kjnt.2019.15.e19.

Changes of Biomarkers before and after Antibiotic Treatment in Spinal Infection

• Lee Y
• Lim J
• Choi SW
• Han S
• Park B
• Youm JY

• KMID: 2461119
• DOI: http://doi.org/10.13004/kjnt.2019.15.e19

Abstract

OBJECTIVE
The laboratory biomarkers used to diagnose spinal infection include white blood cell (WBC) counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Recently, procalcitonin (PCT) has been used as a biomarker to distinguish between bacterial infection and non-bacterial infection. We aimed to compare the changes of conventional biomarker and PCT in patients with spinal infection before and after antibiotic treatment.
METHODS
ESR, CRP, WBC counts, and PCT were measured in 29 patients diagnosed with pyogenic spinal infection at our hospital between May 2016 and December 2018 prior to antibiotic administration. After antibiotic administration, the values were followed up for 4 weeks at 1-week intervals.
RESULTS
A total of 29 patients were enrolled, with a mean age of 67.8 years, consisting of 16 men and 13 women. Twenty-five patients had lumbar infections, and 2 each had cervical and thoracic infections. The mean ESR, CRP, PCT, and WBCs decreased at week 4 of antibiotic treatment compared to their baseline values. CRP and WBCs were significantly decreased after 4 weeks of treatment compared to before treatment. The mean ESR and PCT was not statistically significant compared to pretreatment and after antibiotic treatment (p-value>0.05).
CONCLUSION
Among several biomarker, CRP and WBCs are biomarkers that can aid early evaluation of the effects of antibiotic treatment in pyogenic spondylitis. Although PCT did not have statistical significance, it can be used as a biomarker that reflects the effect of antibiotic and severity of infection.

Keyword

Spondylitis; Biomarkers; C-reactive protein; Calcitonin

MeSH Terms

Bacterial Infections
Biomarkers*
C-Reactive Protein
Calcitonin
Erythrocyte Count
Female
Humans
Leukocytes
Male
Spondylitis
Biomarkers
C-Reactive Protein
Calcitonin

Figure

• 

  FIGURE 1 Changes of biomarker over time before and after antibiotic treatment. (A) ESR, (B) CRP, (C) WBC counts, and (D) PCT. The basal value of CRP and WBC counts before antibiotics treatment were compared with those of each week, and statistical significance was noted (p-value<0.05). 0, Before antibiotic treatment; 1, 3 days after antibiotic treatment; 2, 1 weeks after antibiotic treatment; 3, 2 weeks after antibiotic treatment; 4, 3 weeks after antibiotic treatment; 5, 4 weeks after antibiotic treatment.ESR: erythrocyte sedimentation rate, CRP: C-reactive protein, WBC: white blood cell, PCT: procalcitonin.

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