Bacterial Infections and Mycoses Commons^™

Systemic Antibiotic Selection In Skin And Soft Tissue Infections, Shafira Anindya Purnawan, Windy Keumala Budianti, Sandra Widaty

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Antibiotics are used in daily practice. To properly select antibiotics, it is important to pay attention to the definitive diagnosis, class of antibiotic, dose, interval, route of administration, and exact duration of use.

Discussion: The World Health Organization (WHO) categorizes antibiotics into three groups: Access, Watch, and Reserve—known as the AWaRe classification—to help guide appropriate usage and combat antibiotic resistance. The Gyssens flowchart serves as a valuable tool for clinicians to qualitatively evaluate antibiotic utilization. In skin and soft tissue infections (SSTIs), treatment strategies are tailored according to the characteristics of the infection, including purulence, necrosis, and overall severity. …

Design, Synthesis, And Nmr-Guided Characterization Of A Targeted Covalent Inhibitor-Like Molecule Against Ivyp1 From P. Aeruginosa, Samuel Taylor Moore

Master's Theses

Multi-drug resistance poses a serious threat to future generations and historical antibiotic pipelines; consequently, the medical and economic burdens associated with treating multidrug-resistant bacteria are substantiated. In this context, P. aeruginosa (PA) emerges as one of the most significant healthcare challenges, being a leading cause of resistance-associated mortality worldwide. Despite modern efforts to combat these poor outcomes, drug-resistant cases continue to rise, and the need for novel antibiotic treatment is apparent. To this end, we investigated relevant resistance mechanisms and past antibiotic targets within PA, and in doing so, we identified relationships between peptidoglycan biology and a periplasmic protein, Inhibitor …

Antibiotics For Culture-Negative Neonatal Early-Onset Sepsis: Measuring The Unmeasurable, Dustin D Flannery, Matthew B Green

Rowan-Virtua School of Osteopathic Medicine Departmental Research

No abstract provided.

Understanding Orthopaedic Infections: A Conceptual Approach, Gregory Laborde, Christopher Bloise, George Karam

School of Medicine Faculty Publications

BACKGROUND: Memorizing mounds of facts without having an effective conceptual framework to store them is often an unsuccessful learning style because memory frequently fails without understanding. To accomplish this goal, we offer a framework of ideas called "concept maps". Of the many strategies for metacognition (that is, thinking about thinking), concept mapping is proven to improve meaningful and independent learning. We used this approach to guide understanding of common orthopaedic infections. This paper is not meant to serve as an approach on how to treat, but rather as a storage system with the ability to assist in understanding orthopaedic infections. …

Cabotegravir Maintains Protective Efficacy In The Setting Of Bacterial Stis: A Secondary Analysis Of Hptn 083, Meredith E. Clement, Brett Hanscom, Daniel Haines, Jose A. Bazan, Nuntisa Chotirosniramit, Ryan Kofron, Sharon Mannheimer, Kenneth H. Mayer, Mayara Secco Torres Silva, Lydia Soto-Torres, Alex R. Rinehart, James F. Rooney, A Jennings, K Gomez-Feliciano, Marybeth Mccauley, Beatriz Grinsztejn, Raphael J. Landovitz, Et Al.

School of Medicine Faculty Publications

BACKGROUND: Sexually transmitted infections (STIs) have been shown to facilitate HIV transmission and acquisition. HPTN 083, a global clinical trial, demonstrated superiority of long-acting cabotegravir (CAB-LA) versus daily oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) for HIV prevention among transgender women and cisgender men who have sex with men. This analysis assessed whether CAB-LA maintained protective efficacy when bacterial STIs (syphilis, rectal/urethral gonorrhea and chlamydia) were present. METHODS: STI events per 100 person-years (PY) were calculated, including by subgroups (age, race/ethnicity, gender, education, treatment arm, drug use, alcohol use, region/country, condom usage, partner number, marital status, baseline STI). Association between baseline factors …

An Epidemiological Approach To The Rise In Syphilis In The United States Between 2018 And 2022, Ashley Forrest, Erica Rankin, Lahana Maharjan, Cyril Blavo, Jyotsna Chawla

HCA-NSU MD Research Day

Objective. This study aimed to investigate the recent increase in syphilis rates from 2018 to 2022, utilizing publicly available data from the Centers for Disease Control and Prevention (CDC). Background. Syphilis has seen a dramatic resurgence since 2018, reaching levels not observed since the 1940s. While this increase has prompted significant discourse among healthcare professionals, a comprehensive demographic analysis remains limited. Methods. CDC public datasets from 2018 to 2022 were analyzed descriptively, followed by chi-squared tests and logistic regression modeling conducted using R. The analysis examined syphilis rates across different demographic and behavioral factors, including sex, race/ethnicity, and reported sexual …

To Be Or Not Tb, Gerald Chang, Leidy Huie Martinez Md, Carlos Correa Md, Jose Melendez Md, Brittany Puebla Ms, Yeissen Godinez Md

HCA-NSU MD Research Day

Introduction: Tuberculosis (TB) is an aerosol-transmitted disease that primarily affects the lungs, with active infection presenting as fever, night sweats, weight loss, and productive cough. While it is prevalent worldwide, there may be a lower degree of clinical suspicion in developed countries where it remains uncommon. Therefore, it is important to focus on certain risk factors (travel history, immunosuppression, certain living conditions) in the patient workup. The purpose of this case report is to discuss the presentation and management of a patient with active TB presenting atypically. Case Description: The 47yo male patient with a recent history of pneumonia presented …

Meca In Streptococcus Mutans Is A Multi-Functional Protein, Kassapa Ellepola, Robert C. Shields, Jessica K. Kajfasz, Hua Zhang, Jose A. Lemos, Hui Wu, Zezhang T. Wen

School of Dentistry Faculty Publications

UNLABELLED: Our recent studies have shown that deficiency of MecA in Streptococcus mutans significantly affects cell division, growth, and biofilm formation. In this study, an in vitro mixed-species model, proteomics, and affinity pull-down assays were used to further characterize the MecA-mediated regulation in S. mutans. The results showed that compared with the wild type, UA159, the mecA mutant significantly reduced its production of glucans and weakened its ability to facilitate mixed-species biofilm formation. Relative to the wild type, the mecA mutant also displayed unique characteristics, including colony morphology, growth rate, and biofilm formation that did not fully resemble any of …

From Infection To Encapsulation; A Case Report On Encapsulating Peritoneal Sclerosis, Clinical Challenges And Management, Sidra Memon Md, Jacob Seth Psomiadis Md, Syed Uzair Mahmood, Jennifer Hoffman Md

Advances in Clinical Medical Research and Healthcare Delivery

Encapsulating Peritoneal Sclerosis (EPS) is a rare but deadly sequlae of peritoneal dialysis resulting in intraperitoneal inflammation and fibrosis. The disease itself can present in a variety of ways and is associated with significant morbidity and mortality. Here we present the case of a man in his 50's with a history of chronic peritoneal aspergillus as well as end-stage renal disease on peritoneal dialysis that had multiple admissions for abdominal fluid collections as well as bowel obstruction. After a multidisciplinary approach, the patient was diagnosed with encapsulating peritoneal sclerosis and then started the recommended therapy of tamoxifen and prednisone.

Micro Life, David Burton

HCA Healthcare Journal of Medicine

Painting is what I do to slow my brain and relax my body after a busy day at the hospital. Nothing puts me directly into a flow state like slowly moving acrylic paint across a canvas. This piece titled “Micro Life” depicts the diversity of life constantly surrounding us at the microbiological level everywhere we go. As a strong believer in nutrition and a healthy lifestyle, I know how important our microbiome is to healthy digestion and a properly functioning immune system. On the other side, I have witnessed the devastating effects dangerous microorganisms can have on our already compromised …

Specialized Contact Sites Regulate The Fusion Of Chlamydial Inclusion Membranes, Christine Linton, Jordan Wesolowski, Anna Lobley, Toshiyuki Yamaji, Kentaro Hanada, Fabienne Paumet

Department of Microbiology and Immunology Faculty Papers

The intracellular bacterial pathogen Chlamydia trachomatis replicates within a membrane-bound compartment called the inclusion. Upon infection with several chlamydiae, each bacterium creates its own inclusion, resulting in multiple inclusions within each host cell. Ultimately, these inclusions fuse together in a process that requires the chlamydial protein IncA. Here, we show that inclusions form unique contact sites (inclusion contact sites, ICSs) prior to fusion, that serve as fusogenic platforms in which specific lipids and chlamydial proteins concentrate. Fusion depends on IncA clustering within ICSs and is regulated by PI(3,4)P₂ and sphingolipids. As IncA concentrates within ICSs, its C-terminus likely interacts …

Evaluation Of The Clinical Performance Of A Multistep Algorithm For The Diagnosis Of Clostridioides Difficile Infection And Patient Characteristics In A Clinical Setting, Mayuree Khantipong, Ajcharaporn Sawatpanich, Kanphai Wongjarit, Somying Tumwasorn, Pattama Torvorapanit, Suwatchareeporn Rotcheewaphan Dr.

Chulalongkorn Medical Journal

Background: Clostridioides difficile infection (CDI) is a significant cause of antibiotic-associated diarrhea and colitis. The diagnosis of CDI relies on clinical presentations confirmed by laboratory investigations.

Objectives: This study aimed to evaluate the performance of current diagnostic tests and examine the characteristics of patients associated with CDI in a real hospital setting.

Methods: A total of 299 unformed stool specimens were collected and analyzed using the C. DIFF QUIK CHEK COMPLETE and PCR assays. Patient data were retrospectively reviewed from medical records.

Results: The C. DIFF QUIK CHEK COMPLETE and PCR assays detected toxigenic C. difficile …

Molecular Architecture Of Chitin And Chitosan-Dominated Cell Walls In Zygomycetous Fungal Pathogens By Solid-State Nmr, Qinghui Cheng, Malitha C. Dickwella Widanage, Jayasubba Reddy Yarava, Ankur Ankur, Jean Paul Latgé, Ping Wang, Tuo Wang

School of Medicine Faculty Publications

Zygomycetous fungal infections pose an emerging medical threat among individuals with compromised immunity and metabolic abnormalities. Our pathophysiological understanding of these infections, particularly the role of fungal cell walls in growth and immune response, remains limited. Here we conducted multidimensional solid-state NMR analysis to examine cell walls in five Mucorales species, including key mucormycosis causative agents like Rhizopus and Mucor species. We show that the rigid core of the cell wall primarily comprises highly polymorphic chitin and chitosan, with minimal quantities of β-glucans linked to a specific chitin subtype. Chitosan emerges as a pivotal molecule preserving hydration and dynamics. Some …

Houston, We Have A Problem: Diagnostic Difficulties In The Aids Patient With Tuberculosis Infection, Hector D. Preciado, Maria E. Torres, Muhammad A. Siddiqui, Liza Salloum, Lee Gelpi, Jose E. Campo Maldonado

Research Colloquium

Background: Tuberculosis (TB) is the leading cause of infectious death worldwide with 1.5 million deaths annually and nearly 1/4th of the world’s population (1.7 billion) infected with latent tuberculosis infection (LTBI) in 2014. Its diagnosis conventionally relies on tuberculin skin testing (TST), and Interferon-Gamma Release Assay (IGRA) which relies on the production of Interferon Gamma (IFN-y) in response to Mycobacterium tuberculosis (MTB) specific antigens. IGRA is a useful tool for detecting latent TB disease, and can be used as an adjunct for the diagnosis of active TB cases. Increases in IFN-y levels might support the diagnosis of a new TB …

Prognostic Utility Of The Lactate/Pyruvate Ratio For Mortality In Patients With Sepsis: An Observational Study, Edgar G. Dorsey-Trevino, Olga G. Cantu-Rodriguez, Jose A. Hawing-Zarate, Grecia A. Gonzalez-Cantu, David Gomez-Almaguer, Cesar H. Gutierrez-Aguirre

Research Colloquium

Introduction: Measurement of serum lactate remains pivotal in sepsis evaluation as it is closely related to tissue hypoxia and mortality.^{1, 2} Serum lactate, however, can be elevated due to a myriad of reasons beyond hypoperfusion.³ A proposed alternative to control for serum lactate’s inherent variability is to measure pyruvate concomitantly to calculate the lactate/pyruvate (L/P) ratio.^{4, 5} As pyruvate transforms into lactate in anaerobic conditions, its value decreases in serum, increasing the L/P ratio, hence indicating an actual tissue-perfusion mismatch.⁶ Despite its clinical utility, there is a paucity of evidence evaluating the role of the L/P …

Pleural Effusions In Patients Diagnosed With Pneumonia In Urgent Care Clinics, Nathan C. Dean, Jacqueline R. Eve, Allison M. Butler, James H. Hart, Theadora Sakata, Karen E. Connor, Edward A. Stenehjem, Y.C.G. Lee

The University of Louisville Journal of Respiratory Infections

Introduction: Pleural effusions in patients with community-acquired pneumonia have been associated with worse outcomes in emergency department and hospital inpatient populations, but the incidence of effusions and their outcomes in outpatient urgent care clinics is unknown. This observational cohort study describes patients diagnosed with pneumonia and pleural effusions on upright 2-view chest X-rays performed in urgent care clinics.

Methods: We extracted electronic health record data from January 2019 through December 2020 on all patients over 12 years old with an International Statistical Classification of Diseases 10^th revision diagnosis of pneumonia entered by the treating clinician, plus “possible” or “likely” …

An Unusual Case Of Metronidazole-Induced Encephalopathy In A Patient With Hereditary Hemorrhagic Telangiectasia, Tina H. Dao, Kinza Khan, Christopher D. Jackson

Journal of Community Hospital Internal Medicine Perspectives

Metronidazole-induced encephalopathy (MIE) is a rare toxic encephalopathy. We describe a reversible MIE case in a patient with hereditary hemorrhagic telangiectasia (HHT), treated with metronidazole for brain abscess, who developed dizziness, weakness, dysarthria, and severe dysmetria. His Magnetic Resonance Imaging (MRI) brain revealed bilateral, symmetric lesions in bilateral symmetrical regions of increased intensity in the medullary olives, cerebellar dentate nuclei, and the dorsal pons, all characteristic of MIE. Upon metronidazole discontinuation, the patient experienced significant symptom improvement, with subsequent MRI showing resolution of the lesions

Streptococcus Pneumoniae Spinal Epidural Abscess In An Immunocompetent Patient, Salena Sinnasone, Michelle Blyth

School of Medicine Faculty Publications

Epidural abscesses are a rare diagnosis in immunocompetent patients. The most common risk factors linked with spinal epidural abscesses are intravenous drug use, diabetes mellitus, hepatitis, and iatrogenic factors like prior surgery and catheter usage. The thoracic and lumbar spine are the most common sites of these abscesses. Clinical presentation can include back pain, fever, and neurologic deterioration, with back pain occurring in almost two-thirds of patients. Staphylococcus aureus is the most common causative pathogen. We present a 50 male with no significant past medical or family history who presented with progressive back pain for greater than one week, chills …

A Pilot Program To Improve Tb Care With Primary And Specialty Care Coordination In Tb Public Health Clinic, Priyanka Jadhav, Gabrielle Boudoin, R Miles, Shandrica Seymour, J Parham, Amy Wolfe, Juzar Ali

School of Medicine Faculty Publications

BACKGROUND: The Wetmore Tuberculosis (TB) Clinic in New Orleans serves patients who often lack primary care (PC) or specialty care (SC), which is complicated by comorbidities. An initiative to provide on-site PC and coordinate care aims to enhance TB patient management. METHODS: Data collection involved categorizing patients based on their PC status: Group I (regular PC), Group II (intermittent PC), and Group III (no PC), with on-site Nurse Practitioner-based Bridge Care (NPBC) provided as needed. RESULTS: Over 12 months, 209 out of 354 patients required NPBC and PC/SC coordination, with a 20% shift from Group III to Group I, reducing …

Unveiling The Complexity Of Nocardia Septic Arthritis In An Immunocompromised Patient: A Case Report, Steven A. Kessler, Meghan R. Mansour, Ali Khreisat, Mamon Tahhan

HCA Healthcare Journal of Medicine

Background

Nocardiosis is the systemic manifestation of Nocardia infection, often found in immunocompromised individuals. Nocardia are transmitted via inhalation or skin wounds, disseminating hematogenously to organs and rarely, joints. We present a patient with immunosuppression who developed gout of the knee with superimposed Nocardial septic arthritis and a possible subsequent systemic infection.

Case Presentation

A 74-year-old man presented with left lower extremity swelling and pain. He was taking immunosuppressive medication for antineutrophilic cytoplasmic antibody-positive vasculitis. A week prior, an arthrocentesis test was positive for gout. He received prednisone without improvement. A repeat arthrocentesis was positive for Nocardia farcinica septic arthritis. …

A Clinical Review On Spinal Epidural Abscess: Epidemiology, Pathophysiology, Diagnosis, And Management For Emergency Medicine And Hospitalist Physicians, Madeline A. Guy, Jeffrey S. Guy

HCA Healthcare Journal of Medicine

Spinal epidural abscess (SEA), a critical surgical emergency, demands prompt recognition and intervention to prevent severe complications and fatalities. The incidence of SEA is notably increasing, particularly among individuals with diabetes, intravenous drug use, or a history of invasive spinal procedures. Although SEA can manifest through various clinical symptoms, the presence of its classic triad—back pain, fever, and neurological deficits—is noteworthy despite its occurrence in only 10% to 13% of cases. Identifying this triad is vital due to its high specificity for SEA, which is essential to guiding swift diagnostic and therapeutic actions in a condition where early intervention is …

Molecular Detection Of Pathogenic Bacteria In American Dog Ticks (Dermacentor Variabilis) In Brown County, Nebraska, Nicole Messbarger, Darby Carlson, Keith Geluso, Julie Shaffer

Transactions of the Nebraska Academy of Sciences and Affiliated Societies

Ticks carry and transmit disease pathogens that cause many human illnesses. Many of these diseases in humans are accompanied by a wide variety of symptoms making tick-borne illnesses often difficult to diagnose. The rate of reported tick-borne illnesses in humans has increased during the past decades in the United States, alongside a rise in concern for public health and safety. In northern Nebraska, the American dog tick (Dermacentor variabilis) is the primary tick encountered by humans and domestic animals in the region. This species is a known vector for spotted fever group (SFG) rickettsioses and tularemia (Francisella …

Recruiting Transgender Men In The Southeastern United States For Genital Microbiome Research: Lessons Learned, Olivia Van Gerwen, Z. Alex Sherman, Emma Sophia Kay, Jay Wall, Joy Lewis, Isaac Eastlund, Keonte J. Graves, Saralyn Richter, Angela Pontius, Kristal J. Aaron, Krishmita Siwakoti, Ben Rogers, Evelyn Toh, Jacob H. Elnaggar, Christopher M. Taylor, Nicholas J. Van Wagoner, Christina A. Muzny

School of Medicine Faculty Publications

Background Transgender men (TGM) are underrepresented in genital microbiome research. Our prospective study in Birmingham, AL investigated genital microbiota changes over time in TGM initiating testosterone, including the development of incident bacterial vaginosis (iBV). Here, we present lessons learned from recruitment challenges encountered during the conduct of this study. Methods Inclusion criteria were assigned female sex at birth, TGM or non-binary identity, age ≥18 years, interested in injectable testosterone but willing to wait 7 days after enrollment before starting, and engaged with a testosterone-prescribing provider. Exclusion criteria were recent antibiotic use, HIV/STI infection, current vaginal infection, pregnancy, or past 6 …

Antibiotic Resistance In Livestock: A Literature Review Of Its Consequences And International Effort On Human Antimicrobial Agents Resistant Crisis, Ha Nguyen

Theses and Graduate Projects

Background: Despite their benefits, the overuse of antibiotics in livestock has resulted in negative consequences to human health and the augmenting of an antibiotic-resistant crisis. Countries worldwide have conducted analyses and confirmed the growth of bacterial strains immune to most antibiotics. The widespread use of antibiotics is shown in various sectors, including human medicine and agriculture, leading to the emergence of antibiotic-resistant bacterial strains.

Purpose: This comprehensive literature review focuses on finding the connection between the usage of antibiotics in livestock, the transfer of antibiotic resistance to humans through consumption and exposure, and international efforts to find solutions to antimicrobial …

Syphilitic Gumma Presenting As Squamous Cell Carcinoma Of Vulva: A Case Report, R.M. Nuss, A.J. Lazenby, Holly C. Provost, Tara Castellano

School of Medicine Faculty Publications

Introduction: Tertiary syphilis, a late form of the disease with neurologic, cutaneous, and cardiovascular manifestations, is rarely seen in the United States in modern times. Also called the “great imitator,” syphilis tends to mimic other disease processes, which can lead to a delay in proper diagnosis and treatment. Case: We present the case of a 59-year-old woman who presented for evaluation of possible squamous cell carcinoma of the vulva. After multiple inconclusive biopsies and extensive workup with multiple providers, she was instead found to have cutaneous and neurologic tertiary syphilis. A correct diagnosis was delayed in this patient due to …

Novel Case Of Staphylococcal Scalded Skin Syndrome In A 26-Year-Old With A History Of Ichthyosis, Gunja S. Shah, Sarah Snyder, Kayvan Mirhadi

Advances in Clinical Medical Research and Healthcare Delivery

Staphylococcal scalded skin syndrome (SSSS) is a bacterial toxin-mediated skin disorder that primarily affects neonates but rarely also presents in adults with underlying kidney disease. We present a case of a 26-year-old male with SSSS which was challenging to identify due to an underlying diagnosis of congenital epidermolytic ichthyosis. This case is novel as it is the first documented case of SSSS in an adult with ichthyosis. It highlights the unique challenge of recognizing cutaneous infections in patients with underlying skin disorders especially in the setting of a rural hospital without in-person dermatology coverage.

Pilz Domain-Containing Proteins Regulate Motility In Acinetobacter Baumannii, Gabriel Smith

Electronic Theses and Dissertations

Acinetobacter baumannii is an increasingly multidrug-resistant pathogen contributing to hospital-acquired infections, necessitating a greater understanding of how it interacts with its surroundings. Many bacteria utilize different methods of bacterial motility to move about and interact with these surroundings. A bacterial second messenger, cyclic diguanosine monophosphate (c-di-GMP), can regulate various motility factors that are potentially advantageous for survival in and adaptation to their environment. Concentrations of c-di-GMP are regulated by specific synthesizing and degrading enzymes. Controlled levels of c-di-GMP allow interaction between the c-di-GMP and its binding effectors that induce changes in bacterial phenotypes such as biofilm formation and motility. A …

Candida Albicans Farnesol Synthesis And Secretion, Daniel J. Gutzmann

School of Biological Sciences: Dissertations, Theses, and Student Research

Candida albicans is a polymorphic fungus and opportunistic commensal found primarily in the gastrointestinal and skin of healthy individuals. Several barriers prevent C. albicans from causing disease including a healthy immune system and microbiome. When these barriers become comprised, C. albicans can transition to a pathogen and disseminate through the intestinal mucosa leading to life-threatening bloodstream and invasive infections with mortality rates of up to 64%. Morphogenic plasticity is key to this transition and impacts virulence, adaptation to different host environments, and evasion of host immune responses. One regulator of morphogenesis is farnesol. Farnesol is a secondary metabolite of …

Liposomal Fba And Met6 Peptide Vaccination Protects Mice From Disseminated Candidiasis, Wei-Chiao Huang, Karen Eberle, Jonothan Rosario Colon, Jonathan F. Lovell, Hong Xin

School of Graduate Studies Faculty Publications

UNLABELLED: Epitopes from the cell surface proteins Fba and Met6 are putative vaccine targets for invasive candidiasis. Here, we describe a vaccine approach in which short peptides derived from Fba and Met6 are used in spontaneous nanoliposome antigen particle (SNAP) format. SNAP was enabled by the interaction of cobalt porphyrin phospholipid in liposomes with three histidine residues on the N-terminus of synthetic short peptide immunogens from Fba (F-SNAP), Met6 (M-SNAP), or bivalent Fba and Met6 (FM-SNAP). Liposomes were adjuvanted with synthetic monophosphoryl lipid and QS-21. In mice, immunization with F-SNAP, M-SNAP, or FM-SNAP induced antigen-specific IgG responses and mixed Th1/Th2 …

Risk Factors Associated With Pyogenic Spinal Infections Among Intravenous Drug Users And Nonusers, Vivek Biololikar, Brendan Gleason, Lee Kripke, Robert Merrill, Colin Whitaker, Jon Handal

Einstein Health Papers

PURPOSE: To identify the differences in patient factors, presentation, treatment course, and outcomes of intravenous drug users (IVDA) vs. nonusers (non-IVDA) presenting with pyogenic spinal infections.

METHODS: We identified all cases involving spinal infections at our institution between May 2017 and January 2023. Postsurgical infections were excluded, and patients were separated into IVDA and non-IVDA groups. The patient charts were reviewed and analyzed for statistical or clinically significant differences using RStudio (2019 version 3.6.2). Our institutional review board approved this study, IRB# 2020-277, iRISID-2023-1384.

RESULTS: Fifty patients (29 males and 21 females) with primary pyogenic spinal infections were included in …