Evaluation of thin needle aspiration biopsy in the diagnosis and management of vertebral osteomyelitis (VO)

Hassoun, Ali; Taur, Ying; Singer, Carol

doi:10.1016/j.ijid.2006.02.011

Cited by 29 publications

(33 citation statements)

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“…In this study, we obtained a similar result to previous studies in that antibiotic exposure prior to microbiologic diagnosis was associated with negative outcome of culture (7,10,15). We also analyzed the impact of previous antibiotics in a quantitative manner: if there were 4 or more days of antibiotic exposure, the chance of obtaining positive microbiologic cultures was significantly reduced.…”

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confidence: 75%

“…Some factors are related to the results of microbiologic diagnosis of PVO (3), and among them, an effect of prior antibiotic exposure has been reported in some studies (6,9). Several reports have suggested that prior exposure has a negative effect on microbiologic diagnosis (7,10,15), but others suggest that this is not the case (12). All of these studies had limitations, such as small sample size, heterogeneous patient populations that included tuberculous vertebral osteomyelitis and postoperative vertebral osteomyelitis, and failure to consider duration of antibiotic exposure.…”

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confidence: 99%

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Microbiologically and Clinically Diagnosed Vertebral Osteomyelitis: Impact of Prior Antibiotic Exposure

Kim

Song

Park

et al. 2012

Antimicrob Agents Chemother

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confidence: 75%

mentioning

confidence: 99%

Microbiologically and Clinically Diagnosed Vertebral Osteomyelitis: Impact of Prior Antibiotic Exposure

Kim

Song

Park

et al. 2012

Antimicrob Agents Chemother

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“…Twelve studies with agreement and 13 studies with disagreement were retrieved for review in full published reports. A total of 11 studies met the inclusion criteria for our review, of which seven studies had complete data to be included in the meta-analysis [29][30][31][32][33][34][35]. We attempted to contact the authors of all 11 studies that met the inclusion criteria to obtain missing information and verify abstracted data.…”

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confidence: 99%

The utility of image-guided percutaneous needle aspiration biopsy for the diagnosis of spontaneous vertebral osteomyelitis: a systematic review and meta-analysis

et al. 2015

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“…Prior antibiotic exposure has been reported in some studies to have a negative effect on microbiologic diagnosis (2)(3)(4)(5). In view of this, it is recommended that, for clinically stable patients, biopsy be delayed until at least 48 h after the last antibiotic has been administered (6).…”

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Factors Influencing Culture Positivity in Pyogenic Vertebral Osteomyelitis Patients with Prior Antibiotic Exposure

Kim

Kang

Yoon

et al. 2015

Antimicrob Agents Chemother

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bWe conducted a retrospective cohort study to evaluate factors influencing tissue culture positivity in patients with pyogenic vertebral osteomyelitis exposed to antibiotics before diagnosis. Tissue culture was positive in 48.3% (28/58) of the patients, and the median antibiotic-free period was 1.5 days (range, 0.7 to 5.7 days). In a multivariate analysis, a higher C-reactive protein (CRP) level (adjusted odds ratio [aOR], 1.18; 95% confidence interval, 1.07 to 1.29) and open surgical biopsy (aOR, 6.33; 95% confidence interval, 1.12 to 35.86) were associated with tissue culture positivity. If pyogenic vertebral osteomyelitis (PVO) is suspected, tissue cultures and/or blood cultures are recommended (1). Prior antibiotic exposure has been reported in some studies to have a negative effect on microbiologic diagnosis (2-5). In view of this, it is recommended that, for clinically stable patients, biopsy be delayed until at least 48 h after the last antibiotic has been administered (6). The aims of this study were to investigate the factors influencing tissue culture positivity in patients with PVO who were exposed to antibiotics prior to biopsy and to establish whether an antibiotic-free period improves culture positivity rates.We conducted a retrospective cohort study at three universityaffiliated teaching hospitals from May 2012 through February 2014. Patients with PVO who had been exposed to antibiotics during the 2 weeks before the acquisition of tissue culture specimens were investigated. Patients who were Ͻ18 years old and patients with infectious spondylitis caused by Mycobacterium tuberculosis or fungi were excluded. PVO was diagnosed when the causative microorganism was isolated from spinal or paraspinal tissues or if there were compatible clinical signs or symptoms and radiologic evidence of vertebral infection as described previously (7). The antibiotic-free period was defined as the time interval between the administration of the latest antibiotic and acquisition of specimens for tissue culture. If the antibiotic administered was not active on the microorganism eventually isolated, the patient was considered not to have been exposed to antibiotics. Tissue culture specimens were acquired by percutaneous biopsy or open surgical biopsy. The latter was performed during surgical treatment of the PVO. The Mann-Whitney U test was used to compare continuous variables, and the chi-square test was used to compare categorical variables. Multivariate analysis was performed with binary logistic regression to investigate the factors influencing tissue culture positivity. All P values were two tailed, and P Ͻ 0.05 was considered statistically significant.During the study period, a total of 58 patients with PVO received antibiotics before the acquisition of tissue culture specimens. Blood cultures were done for 53 patients, and 30.2% (16/ 53) gave positive results. The tissue culture positivity rate was 48.3% (28/58). Tissue culture specimens of 48 patients were obtained by computed-tomography or fluoroscopy-guided percu...

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Evaluation of thin needle aspiration biopsy in the diagnosis and management of vertebral osteomyelitis (VO)

Abstract: Phylogeny of the genus Nocardia based on reassessed 16S rRNA gene sequences reveals underspeciation and division of strains classified as Nocardia asteroides into three established species and two unnamed taxons.

Cited by 29 publications

References 3 publications

Microbiologically and Clinically Diagnosed Vertebral Osteomyelitis: Impact of Prior Antibiotic Exposure

Microbiologically and Clinically Diagnosed Vertebral Osteomyelitis: Impact of Prior Antibiotic Exposure

The utility of image-guided percutaneous needle aspiration biopsy for the diagnosis of spontaneous vertebral osteomyelitis: a systematic review and meta-analysis

Factors Influencing Culture Positivity in Pyogenic Vertebral Osteomyelitis Patients with Prior Antibiotic Exposure

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