Lopez J, et al. - Researchers performed this retrospective comparative study to compare the characteristics of patients with spontaneous coagulase-negative staphylococci (CoNS)-spondylodiscitis with those patients with Staphylococcus aureus (SA) spondylodiscitis. At least 10% of spontaneous spondylodiscitis cases were involved in CoNS-spondylodiscitis and was more common in elderly patients, afflicted by comorbidities. Its presentation was less virulent than that of those with SA-spondylodiscitis.

• From 2000 to 2015, this study involved 147 spontaneous infectious spondylodiscitis cases.
• The researchers compared 26 cases of CoNS-spondylodiscitis (15 confirmed) with 30 cases of SA-spondylodiscitis.
• If the same CoNS was isolated in at least 2 samples at 2 different times, CoNS infection was considered confirmed.

• Patients with CoNS-spondylodiscitis were found to be older (70 vs. 61 years of age; p=0.01), who had associated cancer more often (15% vs. 0%; p=0.04) and had a longer diagnostic delay (>15 days in 88% vs. 60%; p=0.01); experienced fever less often (19% vs. 50%; p=0.01), and had lower white blood cell (7.6 vs. 9.9G/L; p = 0.01) and polymorphonuclear leucocyte counts (5.6 vs. 7.5G/L; p=0.04).
• In comparison with patients with SA infection, patients with CoNS spondylodiscitis had less pronounced inflammatory syndrome (erythrocyte sedimentation rate [ESR]: 62 vs. 81 mm at 1 h; p = 0.03; CRP: 60 vs. 147 mg/L; p=0.0003) and less common (ESR < 30 mm: 23% vs. 0%; p=0.01; CRP < 10 mg/L: 23% vs. 0%; p=0.005).
• Most often an intravascular catheter was the infection entry site (20% vs. 3%; p=0.008).
• Between CoNS and SA, the level of positive percutaneous needle biopsies was similar.
• SA infections was identified in 2 patients who died.