Evidence map›Paper›PMID 28391384›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2017

The role of Xpert MTB/RIF assay in the diagnosis of tubercular spondylodiscitis.

Justin Arockiaraj, Joy S Michael, Rohit Amritanand, Kenny Samuel David, Venkatesh Krishnan

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 5 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  5. XpertThe Cochrane database of systematic reviews · 2018
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Justin ArockiarajDepartment of Orthopaedics, Spinal Disorders Surgery, Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu, 632004, India. svjustin.arockiaraj@gmail.com.
Joy S MichaelDepartment of Microbiology, Christian Medical College, Ida Scudder Road, Vellore, 632004, India.
Rohit AmritanandDepartment of Orthopaedics, Spinal Disorders Surgery, Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu, 632004, India.
Kenny Samuel DavidDepartment of Orthopaedics, Spinal Disorders Surgery, Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu, 632004, India.
Venkatesh KrishnanDepartment of Orthopaedics, Spinal Disorders Surgery, Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu, 632004, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aims to assess the accuracy of the Xpert MTB/RIF assay in the diagnosis of tubercular spondylodiscitis and to identify its role in detecting Rifampicin resistance in patients with infective spondylodiscitis.

methodsA retrospective study including 348 patients suspected to have infective spondylodiscitis was done. Tissue/pus samples obtained were sent for culture, histopathology and Xpert MTB/RIF assay. All patients who were confirmed to have tubercular spondylodiscitis and those patients who were suspected on clinico-radiological basis were also treated with anti-tuberculous chemotherapy for a period of 9 months. The efficacy of the Xpert MTB/RIF assay was assessed in terms of sensitivity and specificity when compared to culture, histopathology, and Composite reference standard (CRS).

resultsDuring this study period of 24 months, a total of 348 patients were treated for infective spondylodiscitis. 254 patients were treated for tuberculosis following a smear positivity, culture positivity, and histopathology report or empirically based on clinico-radiological findings. The sensitivity and specificity of the Xpert MTB/RIF assay when compared to culture were 88.4 and 63.7%, respectively. When compared to both culture and histopathology reports it was 80.9 and 80.6%. The sensitivity and specificity of the Xpert MTB/RIF assay when compared to composite reference standard were 71.2 and 100%, respectively. The sensitivity of the assay to detect Rifampicin resistance was 100%. The prevalence of Rifampicin resistance was 5.1%.

conclusionThis study recommends Xpert MTB/RIF assay for early detection of Mycobacterium tubercular spondylodiscitis and Rifampicin resistance.

Indexed as

DiscitisDrug Resistance, BacterialHumansMolecular TypingMycobacterium tuberculosisRetrospective StudiesSensitivity and SpecificityTuberculosis, SpinalDiagnosisRifampicinTreatmentTuberculosisXpert MTB/RIF assay

Identifiers

PMID28391384

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.