Answer to the Letter to the Editor of Soundararajan DCR et al. concerning “Bacteria: back pain, leg pain and Modic sign—A surgical multicentre comparative study” by Fritzell P, et al. (Eur Spine J [2019]; doi:10.1007/s00586-019-06164-1) (original) (raw)
Related papers
European Spine Journal, 2004
A local inflammatory and potentially painful response, of which the ultimate cause is unknown, has been described in nervous tissues in contact with degenerated disc material in patients with low back and leg pain. With the rationale that a possible cause of such inflammation could be bacterial infection, we utilized PCR (polymerase chain reaction) amplification of the 16S rRNA (ribosomal RNA) gene followed by gene sequencing, to investigate whether bacterial DNA might be detected in the degenerative discs of 10 patients operated for disc herniation or post-discectomy syndrome. One patient with disc hernia harbored DNA homologous to Bacillus cereus, and in one patient suffering from post-discectomy syndrome, Citrobacter braakilfreundii DNA was detected. The finding demonstrates that 16S rRNA PCR can be a useful tool in search of bacterial DNA in degenerated discs, which in turn may be indicative of low-grade infection, manifesting itself only as pain rather than as clinical infection.
Bacterial PCR in the diagnosis of joint infection
Annals of the Rheumatic Diseases, 2001
Objectives-To evaluate the value of broad range bacterial PCR in the diagnosis of joint infection and to find out if there are bacteria causing arthritis which are not cultivable by the present methods. Methods-Polymerase chain reaction (PCR) with broad range bacterial primers and DNA sequencing (bacterial PCR) was used to analyse 154 synovial fluid (SF) samples from patients with diVerent arthritic diseases. Results-Bacterial DNA was detected in 18 SF samples, including samples from six patients with culture proven purulent arthritis, and from three patients with possible purulent arthritis. Three samples from patients with culture confirmed purulent arthritis remained negative in bacterial PCR. Conclusions-The results indicate that in the usual diagnostic laboratory setting bacterial PCR does not oVer any obvious advantage over bacterial culture in the microbiological diagnosis of joint infection.
The Journal of rheumatology, 2002
Bacteria and/or their antigens are thought to play a role in the pathogenesis of reactive arthritis (ReA). Polymerase chain reaction (PCR) using the 16S ribosomal RNA-PCR method was used to identify bacterial DNA in synovial fluid (SF) and tissue (ST) in a well defined group of patients with chronic ReA. In addition, species found were identified by means of sequence analysis. We examined 15 ST and 5 SF samples of 15 patients with ReA, 5 ST samples of 5 patients with osteoarthritis (OA), and 8 SF from 8 patients with closed traumatic knee injuries using a nested PCR with universal 16S rRNA primers. In addition, a nested PCR was developed to detect DNA sequences of Salmonella sp. and Mycoplasma sp. Automated sequencing and comparative data analysis (GenBank) were also performed to identify the species. Bacterial DNA was identified in 8 cases, 5 ST and 3 SF; Chlamydia trachomatis (n = 2), Pseudomonas sp. (n = 3), and Bacillus cereus (n = 2) were the most common microorganisms identifi...
The Role of Polymerase Chain Reaction (PCR) in Diagnosis
Objective: The aim of this study was to evaluate the role of polymerase chain reaction (PCR) in the diagnosis of spinal tuberculosis after 2 weeks of preoperative anti-tuberculosis treatment and to compare PCR to the Löwenstein - Jensen Culture (LJC) and histopathological examination (HPE) methods. Methods: Twenty-five patients were included in this study. Sixteen patients were diagnosed and treated for spinal tuberculosis based on clinical and radiological evidence. Nine patients were controls. The LJC method and HPE of the specimen were performed according to hospital protocol. PCR was performed using primer encoding insertion of sequences IS6110 for mycobacterium tuberculosis complex. Clinical findings and radiological features were the gold standard for comparison. Results: PCR results were 15 positive and one negative. The sensitivity and specificity of PCR was 94% and 100% respectively (with 95% confidence interval [CI] 67% to 99% and 63% to 100%, respectively). HPE results showed 13 were positive and 3 negative in the spinal tuberculosis group; for the control group, all were negative. Sensitivity and specificity value of HPE was 82 % and 100% respectively (with 95% confidence interval [CI] 54% to 95% and 63% to 100%, respectively). Use of LJC showed only one was positive and 15 were negative in the spinal tuberculosis group whole all nine in the control group were negative. Sensitivity and specificity value of LJC was 6% and 100% respectively (with 95% confidence interval [CI] 0.3% to 32% and 63% to 100%, respectively). Conclusion: Our findings showed that the PCR for Mycobacterium tuberculosis is reliable as a method for diagnosis of spinal tuberculosis, even after of 2 weeks of anti-TB treatment, with an overall sensitivity of 94% and specificity of 100%.
Analytical Biochemistry, 1997
a clinical specimen. Conversely, if properly controlled, the failure of this method to detect such organisms can The use of a broad-range PCR to target conserved provide evidence supporting rejection of the bacterial sequences in the bacterial ribosome has long been recetiology hypothesis, an important aspect unique to ognized as an approach to investigating idiopathic huthis approach. For those bacterial sequences that are man diseases for the presence of bacteria. An imdetected, the ability to localize them in situ would help portant example is rheumatoid arthritis where the define their histologic context and hence facilitate hypothesis of a bacterial etiology remains viable detheir pathogenetic interpretation. The present method spite failure of previous methods to identify a causshould therefore be appropriate for use in systematiative organism. Practical implementation of this stratcally studying rheumatoid arthritis as well as a numegy, however, was impeded by requirements unique ber of other important idiopathic disorders where a to the study of these diseases. Hence, an adequately bacterial etiology is suspect. ᭧ 1997 Academic Press characterized method for achieving this has not appeared. We now describe such a method based on the use of a broadly reactive pair of deoxyinosine-containing primers. Detailed characterization addressing Nucleic acid probes have provided an important althese requirements provided evidence that DNA from ternative to traditional culture-based methods of idenat least 96% of potential prokaryotic pathogens would tifying bacteria (1). In conjunction with the polymerase be detected. The sensitivity was shown to approximate chain reaction (PCR), they have been increasingly used that of a single organism per reaction. Importantly, for clinical diagnosis. Largely unexplored, however, is this sensitivity was shown to be maintained among their use for investigating such idiopathic diseases as multiple targets and to be unimpaired by a large exrheumatoid arthritis, where circumstantial evidence cess of human DNA. Similar results were obtained with supports the hypothesis of a bacterial infectious cause. extracts of inflamed human synovial fluid to which as This hypothesis remains intact despite decades of little as 0.01 pg of bacterial DNA or, alternately, a sinfailed attempts to identify a causative organism (2) begle organism per reaction was added. This method was cause of the inability, even in principle, of culturealso shown correctly to detect the causative bacteria based methods to provide evidence allowing its rejecin clinically infected synovial fluids, further docution. Indeed, recent work has, if anything, reinforced menting its applicability to such specimens. Finally, it this hypothesis. An important illustrative example is was converted to an in situ method by which bacterial the recognition of a bacterial etiology for Lyme disease sequences were histochemically localized to Michaewhich had previously been confused with rheumatoid lis-Guttman bodies in tissue sections from a patient arthritis (3). It seems likely that additional idiopathic with malakoplakia, a poorly understood infectious disdisorders are similarly due to unrecognized bacterial ease. The broad reactivity and high sensitivity infection. A strategy is therefore needed for systematiachieved by this approach translate into a high likelihood of detecting an unknown bacterium if present in cally examining candidate diseases for such infection.