Unveiling the microbiological experience in exploring spinal TB cases from a tertiary care center

IF 1.5 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology Pub Date : 2026-03-01 Epub Date: 2026-01-16 DOI:10.1016/j.ijmmb.2026.101050

Jaya Biswas , Kiran Bala , Neha Nityadarshini , Leander Jose , Vivek Shankar , Urvashi B. Singh

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引用次数: 0

Abstract

Purpose

Spinal tuberculosis, a severe form of extrapulmonary tuberculosis, poses significant diagnostic and therapeutic challenges, often leading to neurological complications and deformity. Microbiological confirmation is crucial for diagnosis and effective treatment. We aim to evaluate the microbiological profile and diagnostic yield of various methods in spinal TB cases at a tertiary care centre and to correlate with clinical features and treatment outcomes.

Methods

A prospective study was conducted on samples from patients with suspected spinal TB (n = 58) from July 2023 to September 2024. All samples were processed using Ziehl-Neelsen (ZN) staining for acid-fast bacilli (AFB), culture on Lowenstein-Jensen (LJ) medium, BACTEC MGIT 960 liquid culture system, and GeneXpert MTB/RIF assay for rapid detection of MTB and rifampicin sensitivity. Relevant demographic, clinical, and radiological data were collected and analyzed. Based on susceptibility to drugs of culture isolates, treatment was started to see the outcome, and follow-ups were done with the patients.

Results

A total of 19 spinal TB cases were microbiologically confirmed, out of 58 clinically suspected spinal TB cases, with a male predominance (57.9 %) and age range of 13–72 years. The most common symptom was lower back pain (89.5 %). GeneXpert was positive in all cases, detecting rifampicin resistance in 7(36.8 %). Culture was positive in 11 cases. ZN staining was positive in 15.8 % of direct samples. Histopathology showed granulomatous inflammation in 9 (47.3 %) of cases. MRI confirmed infective spinal involvement in 17(89.5 %) patients. MDR-TB regimen was initiated in 7 patients. Overall recovery was good, except one case of neuropathy and one mortality.

Conclusions

A combination of smear microscopy, culture, and molecular diagnostics significantly improves the microbiological diagnosis of spinal TB. GeneXpert offers rapid, reliable results, especially in rifampicin resistance detection. Early and accurate microbiological confirmation, coupled with clinical-radiological correlation, is essential for effective management and improved patient outcomes.

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揭示微生物的经验，探索脊柱结核病例从三级保健中心。

目的：脊柱结核是肺外结核的一种严重形式，对诊断和治疗提出了重大挑战，通常导致神经系统并发症和畸形。微生物学确认对诊断和有效治疗至关重要。我们的目的是评估在三级保健中心的脊柱结核病例中各种方法的微生物谱和诊断产量，并与临床特征和治疗结果相关联。方法：对2023年7月至2024年9月期间疑似脊柱结核患者（n=58）进行前瞻性研究。所有样品均采用Ziehl-Neelsen （ZN）染色法检测抗酸杆菌（AFB）， Lowenstein-Jensen （LJ）培养基培养，BACTEC MGIT 960液体培养系统，GeneXpert MTB/RIF法快速检测MTB和利福平敏感性。收集并分析了相关的人口学、临床和放射学资料。根据培养分离菌对药物的敏感性，开始治疗，并对患者进行随访。结果：58例脊柱结核临床疑似病例中，微生物学确诊19例，男性居多（57.9%），年龄13 ~ 72岁。最常见的症状是腰痛（89.5%）。GeneXpert检测结果均为阳性，其中7例（36.8%）检测出利福平耐药。11例培养阳性。15.8%的直接样品ZN染色阳性。组织病理学检查显示肉芽肿性炎症9例（47.3%）。MRI证实17例（89.5%）患者有感染性脊柱受累。7名患者开始了耐多药结核病治疗方案。除1例神经病变和1例死亡外，整体恢复良好。结论：涂片镜检、培养和分子诊断相结合可显著提高脊柱结核的微生物学诊断。GeneXpert提供快速、可靠的结果，特别是在利福平耐药性检测方面。早期和准确的微生物学确认，加上临床-放射学相关性，对于有效管理和改善患者预后至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian Journal of Medical Microbiology IMMUNOLOGY-

CiteScore

2.20

自引率

0.00%

发文量

154

审稿时长

73 days

期刊介绍： Manuscripts of high standard in the form of original research, multicentric studies, meta analysis, are accepted. Current reports can be submitted as brief communications. Case reports must include review of current literature, clinical details, outcome and follow up. Letters to the editor must be a comment on or pertain to a manuscript already published in the IJMM or in relation to preliminary communication of a larger study. Review articles, Special Articles or Guest Editorials are accepted on invitation.