The comparison of serum procalcitonin and IL-6 levels with CRP levels on the patients who are diagnosed pyogenic and granulomatous vertebral osteomyelitis and treating with antimicrobials.

Aim: VO is an infection that incidence is increasing due to diagnostic possibilities in recent years. The treatment with the difficulty in determining the effect is empirically regulated. For this reason, in our country, laboratory markers have great importance in follow-up and treatment of the infection. In this study, it was planned to compare the values of BK, PMNL, CRP and ESH to PCT and IL-6, which are not used in practice, for diagnosis and treatment of patients admitted to Afyon Kocatepe University Infectious Diseases and Clinical Microbiology Department with VO diagnosis. Methods: The study was performed prospectively in Afyon Kocatepe University Infectious Diseases and Clinical Microbiology Clinic between August 2016 and January 2018. All adult patients with VO diagnosis were included in the study. The patients were divided into two groups: pyogenic and granulomatous VO. Levels of serum BK, PMNL, Hb, PLT, CRP, ESH, PCT and IL-6 levels were measured immediately before antibiotic therapy and at 2nd, 4th and 8th weeks of antibiotherapy and at 12th and 24th weeks in patients with prolonged treatment. After appropriate microbiological sampling, serum samples were taken for study. The results of microbiological sampling, treatments, changes in laboratory parameters and prognosis of the patients were evaluated. Results: Results of thirty patients were evaluated. Pyogenic VO was detected in 22 patients (73.3%) and granulomatous VO in 8 patients (26.7%). Granulomatous VO cases; Brucellosis was present in 6 (20%) and TB was present in 2 (6.7%). The ratio of female / male was found to be 1/1. The most common symptom was spinal pain (93.3%) and the most important risc factor was spinal surgery (43.3%). When blood culture is taken from the whole patient; tissue culture was taken from 70%. The causative pathogen could be determined in 10 of the patients (33.3%). Three patients (10%) had CNS, 2 patients (6.6%) had P. aeruginosa, 2 patients (6.6%) had M. tuberculosis, 1 patient (3.3%) had S. aureus, 1 patient (3.3%) had E. cloaca complex. ESH and IL-6 in all of the patients, CRP; in 96.6% of cases, BK; 31.8% in the pyogenic group, 12.5% in the granulomatous group, and PCT was found above the threshold in only one, before treatment. Following the treatment, increase in mean Hb values, decrease in CRP, ESR, PCT and IL-6 values were observed in parallel with the clinical response. Conclusion: ESH, CRP, PCT and IL-6 biomarkers are valuable indicators following treatment. In particular, it is thought that IL-6 value is the most important parameter although it is not statistically significant following the treatment.