Epidemiology and Infection
Volume 145, Issue 10, 2017, Pages 2152-2160

The changing epidemiology of spinal tuberculosis: The influence of international immigration in Catalonia, 1993-2014 (Article) (Open Access)

Peghin M. , Rodriguez-Pardo D.* , Sanchez-Montalva A. , Pellisé F. , Rivas A. , Tortola T. , Aguilar J. , Almirante B. , Pigrau C.
  • a Department of Infectious Diseases, Hospital Universitari de la Vall d'Hebron, P Vall d'Hebron 119-129, Barcelona, 08035, Spain, Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain, Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
  • b Department of Infectious Diseases, Hospital Universitari de la Vall d'Hebron, P Vall d'Hebron 119-129, Barcelona, 08035, Spain, Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain, Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
  • c Department of Infectious Diseases, Hospital Universitari de la Vall d'Hebron, P Vall d'Hebron 119-129, Barcelona, 08035, Spain, Infectious Disease Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain
  • d Department of Orthopaedic Surgery, Spine Unit, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain
  • e Department of Radiology, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain
  • f Department of Microbiology, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain
  • g Department of Infectious Diseases, Hospital Universitari de la Vall d'Hebron, P Vall d'Hebron 119-129, Barcelona, 08035, Spain
  • h Department of Infectious Diseases, Hospital Universitari de la Vall d'Hebron, P Vall d'Hebron 119-129, Barcelona, 08035, Spain, Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain, Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
  • i Department of Infectious Diseases, Hospital Universitari de la Vall d'Hebron, P Vall d'Hebron 119-129, Barcelona, 08035, Spain, Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain, Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain

Abstract

The overall incidence of spinal tuberculosis (TB) appears to be stable or declining in most European countries, but with an increasing proportion of cases in the foreign-born populations. We performed a retrospective observational study (1993-2014), including all cases of spinal TB diagnosed at a Barcelona hospital to assess the epidemiological changes. Fifty-four episodes (48·1% males, median age 52 years) of spinal TB were diagnosed. The percentage of foreign-born residents with spinal TB increased from 14% to 45·2% in the last 10 years (P = 0·017). Positive Mycobacterium tuberculosis testing in vertebral specimens was 88·2% (15/17) for GeneXpert MTB/RIF. Compared with natives, foreign-born patients were younger (P < 0·01) and required surgery more often (P = 0·003) because of higher percentages of paravertebral abscess (P = 0·038), cord compression (P = 0·05), and persistent neurological sequelae (P = 0·05). In our setting, one-third of spinal TB cases occurred in non-native residents. Compared with natives, foreign-born patients were younger and had greater severity of the disease. The GeneXpert MTB/RIF test may be of value for diagnosing spinal TB. © Cambridge University Press 2017.

Author Keywords

tuberculosis Pott disease spinal tuberculosis GeneXpert MTB/RIF Immigration

Index Keywords

tuberculous pleurisy China erythrocyte sedimentation rate Human immunodeficiency virus infection human neurologic disease ethnology prognosis Humans migrant male Emigrants and Immigrants Spain female very elderly tuberculous spondylitis polymerase chain reaction Tuberculosis, Spinal isolation and purification Article major clinical study adult migration Emigration and Immigration disease severity Abscess Morocco miliary tuberculosis radicular pain paravertebral abscess infliximab spinal cord compression Pakistan spondylitis quadriplegia Clostridium difficile infection cauda equina syndrome epidural abscess DRESS syndrome spine malformation paraspinal muscle Africa south of the Sahara comorbidity middle aged controlled study Mycobacterium tuberculosis Aged ofloxacin lung tuberculosis tuberculostatic agent observational study diagnostic test accuracy study sensitivity and specificity Moxifloxacin Retrospective Studies C reactive protein fever isoniazid Amikacin serology paraplegia ethambutol retrospective study ethionamide rifampicin Bolivia pyrazinamide backache immigration rash Incidence streptomycin urogenital tuberculosis chronic kidney failure capreomycin diabetes mellitus alcoholism liver toxicity liver transplantation gastrointestinal symptom drug withdrawal microbiology
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85019840324&doi=10.1017%2fS0950268817000863&partnerID=40&md5=250bf203670ea3447640d42b1798baee
DOI: 10.1017/S0950268817000863
ISSN: 09502688
Cited by: 4
Original Language: English