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Microbiological diagnosis of spinal tuberculosis

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Abstract

Purpose

The purpose of this study was to review the clinical features and diagnosis of spinal tuberculosis cases reported in the literature.

Methods

A medical literature search in the Medline Pubmed database was undertaken to review tuberculosis spinal infection and extra-pulmonary tuberculosis diagnosis improvement. We introduced the following search items and boolean operators: "spinal infection", "spinal tuberculosis infection", "microbiological diagnosis of spinal tuberculosis" and "spinal tuberculosis PCR." Single cases or series without microbiological diagnosis were rejected. Manuscript language was restricted to Spanish, French, and English versions.

Results and conclusions

Spinal tuberculosis is more common in developing countries and is probably underdiagnosed. Delayed diagnosis is characteristic; it worsens the prognosis and increases morbidity. The microbiological diagnosis is crucial for several reasons. Despite surgical treatment, medical treatment with anti-tuberculous drugs is always necessary. A total of 20–40% of the spinal tuberculosis patients show another locus of infection. Pulmonary location can become a public health problem. Previously treated patients for other tuberculosis locations, incomplete treatments, or poor adherence can change the M. tuberculosis sensitivity pattern. Drug resistance test becomes a major need in the microbiology laboratory. PCR diagnostic techniques advance the diagnosis and increase the sensitivity and specificity rate.

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References

  1. Polley P, Dunn R (2009) Noncontiguous spinal tuberculosis: incidence and management. Eur Spine J 118:1096–1101

    Article  Google Scholar 

  2. Cormican L, Hammal R, Messenger J, Milburn HJ (2006) Current difficulties in the diagnosis and management of spinal tuberculosis. Postgrad Med J 182:46–51

    Article  Google Scholar 

  3. Milburn H (2007) Key issues in the diagnosis and management of tuberculosis. J R Soc Med 1100:134–141

    Article  Google Scholar 

  4. Naim-ur-Rahman (1980) Atypical forms of spinal tuberculosis. J Bone Joint Surg Br 62-B(2):162–165

    PubMed  Google Scholar 

  5. Bailey HL, Gabriel M, Hodgson AR, Shin JS (1972) Tuberculosis of the spine in children. J Bone Joint Surg Am 197254:1633–1657

    Google Scholar 

  6. Chen S-H, Lin W-C, Lee C-H, Chou Wen-Yi (2008) Spontaneous infective spondylitis and mycotic aneurysm: incidence, risk factors, outcome and management experience. Eur Spine J 117:438–444

    Google Scholar 

  7. Arora S, Kumar R (2011) Tubercular spinal epidural abscess involving the dorsal-lumbar-sacral region without osseous involvement. J Infect Dev Ctries 15(7):544–549

    Google Scholar 

  8. Agrawal VR, Patgaonkar P, Nagariya SP (2010) Tuberculosis of spine. J Craniovert Jun Spine 101:74–85

    Article  Google Scholar 

  9. Beiner JM, Grauer J, Kwon BK, Vaccaro AR (2003) Postoperative wound infections of the spine. Neurosurg Focus 115(3):14

    Google Scholar 

  10. Oguz E et al (2008) A new classification and guide for surgical treatment of spinal tuberculosis. Int Orthop 132(127):133

    Google Scholar 

  11. Nair SS (2011) Ethical aspects of the Revised National Tuberculosis Control Programme. Indian J Med Ethics 8(2):102–106

    Google Scholar 

  12. Lee KY, Sohn SK, Hwang KS (1999) Comparison of pyogenic and tuberculous spondylitis. J Korean Soc Spine Surg 6(3):443–450

    Google Scholar 

  13. AlOthman A, Memish ZA, Awada A et al (2001) Tuberculous spondylitis: analysis of 69 cases from Saudi Arabia. Spine 26:565–570

    Article  Google Scholar 

  14. Pintado-García V (2008) Espondilitis infecciosa. Enferm Infecc Microbiol Clin 226(8):510–517

    Article  Google Scholar 

  15. Solís-García DP, Vives-Soto M, Lizán-García M, Martínez-Alfaro E, Segura-Luque JC, SoleraSantos J (2005) Incidencia de la espondilitis infecciosa en la provincia de Albacete. Enferm Infecc Microbiol Clin 123:545–550

    Google Scholar 

  16. Beronius M, Bergman B, Andersson R (2001) Vertebral osteomyelitis in Göteborg, Sweden: a retrospective study of patients during 1990–95. Scand J Infect Dis 133(7):527–532

    Google Scholar 

  17. Nagashima H, Yamane K, Nishi T, Nanjo Y, Teshima R (2010) Recent trends in spinal infections: retrospective analysis of patients treated during the past 50-years. Int Orthop 34(3):395–399

    Article  PubMed  Google Scholar 

  18. Weng CY, Chi CY, Shih PJ, Ho CM, Lin PC, Chou CH et al (2010) Spinal tuberculosis in non-HIV-infected patients: 10 year experience of a medical center in Central Taiwan. J Microbiol Immunol Infect 43(6):464–469

    Article  PubMed  Google Scholar 

  19. Kim CJ, Song KH, Jeon JH, Park WB, Park SW, Kim HB et al (2010) A comparative study of pyogenic and tuberculous spondylodiscitis. Spine 35(21)

  20. Smith I (2003) Mycobacterium tuberculosis pathogenesis and molecular determinants of virulence. Clin Microbiol Rev 116:463–496

    Article  Google Scholar 

  21. Taneja B, Mande SC (2001) Metal ions modulate the plastic nature of Mycobacterium tuberculosis chaperonin-10. Protein Eng 114:391–395

    Article  Google Scholar 

  22. Cheng VCC, Yam WC, Hung IFN, Woo CY, Lau SKP, Tang BSF et al (2004) Clinical evaluation of the polymerase chain reaction for the rapid diagnosis of tuberculosis. J Clin Pathol 257:281–285

    Article  Google Scholar 

  23. World Health Organization (2007) Global tuberculosis control. Surveillance, planning, financing. WHO, Geneva

  24. Portillo L, Morris SL, Panduro A (2000) Rapid and efficient detection of extra-pulmonary Mycobacterium tuberculosis by PCR analysis. Int J Tuberc Lung Dis 4(4):361–370

    Google Scholar 

  25. Runa F, Yasmin M, Hoq MM, Begum J, Rahman AS, Ahsan CR (2001) Molecular versus conventional methods: Clinical evaluation of different methods for the diagnosis of tuberculosis in Bangladesh. J Microbiol Immunol Infect 1:101–105

    Google Scholar 

  26. Steingart K et al. (2011) Commercial serological tests for the diagnosis of active pulmonary and extrapulmonary tuberculosis: an updated systematic review and meta-analysis. www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001062. Accessed 02 January 2012

  27. Collins I, Wilson-MacDonald J, Chami G, Will Burgoyne P, Vineyakam TB et al (2008) The diagnosis and management of infection following instrumented spinal fusion. Eur Spine J 117:445–450

    Article  Google Scholar 

  28. Pertuiset E, Beaudreuil J, Lioté F et al. (1999) Spinal tuberculosis in adults. A study of 103 cases in a developed country, 1980–1994. Medicine (Baltimore) 178(5):309–320

    Google Scholar 

  29. Boondireke S, Mungthin M, Tan-ariya P, Boonyongsunchai P, Naaglor T et al (2010) Evaluation of sensitivity of multiplex PCR for detection of Mycobacterium tuberculosis and Pneumocystis jirovecii in clinical samples. J Clin Microbiol 148(9):3165–3168

    Article  Google Scholar 

  30. Amin I, Idrees M, Awan Z, Shahid M, Afzal S, Hussain A (2011) PCR could be a method of choice for identification of both pulmonary and extra-pulmonary tuberculosis. BMC Res Notes 4(1):332

    Article  PubMed  Google Scholar 

  31. Colmenero JD, Morata P, Ruiz-Mesa JD, Bautista D, Bermúdez P, Bravo MJ et al (2010) Multiplex real-time polymerase chain reaction: a practical approach for rapid diagnosis of tuberculous and Brucellar vertebral osteomyelitis. Spine 35(24)

  32. Queipo-Ortuño MI, Colmenero JD, Bermúdez JD, Bravo MJ, Morata P (2009) Rapid differential diagnosis between extrapulmonary tuberculosis and focal complications of Brucellosis using a multiplex real-time PCR assay. PLoS One 14(2):e4526

    Article  Google Scholar 

  33. Kalita J, Misra UK, Mandal SK, Srivastava M (2005) Prognosis of conservatively treated patients with Pott’s paraplegia: logistic regression analysis. J Neurol Neurosurg Psychiatry 176:866–868

    Article  Google Scholar 

  34. Medical Research Council Working Party on Tuberculosis of the Spine (1993) Controled trial of short-course regimens of chemotherapy in the ambulatory treatment of spinal tuberculosis. J Bone Joint Surg Br 175:240–248

    Google Scholar 

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Authors and Affiliations

  1. Clinical Microbiology Department, Clinico San Carlos Hospital, C/ Prof. Martin Lago s/nº, 28040, Madrid, Spain

    Paloma Merino, Francisco J. Candel, Israel Gestoso, Elvira Baos & Juan Picazo

Authors
  1. Paloma Merino
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  2. Francisco J. Candel
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  3. Israel Gestoso
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  4. Elvira Baos
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  5. Juan Picazo
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Corresponding author

Correspondence to Paloma Merino.

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Merino, P., Candel, F.J., Gestoso, I. et al. Microbiological diagnosis of spinal tuberculosis. International Orthopaedics (SICOT) 36, 233–238 (2012). https://doi.org/10.1007/s00264-011-1461-x

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  • DOI: https://doi.org/10.1007/s00264-011-1461-x

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