Laboratory diagnostics for primary spinal infections in pediatric and adult populations: a narrative review
Primary spinal infection (PSI) is a generic term covering a heterogeneous group of infections that can affect the vertebral body, intervertebral disks, the content of the medullary cavity, and adjacent paraspinal tissues. Patients’ characteristics can vary significantly, notably according to their a...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | North American Spine Society Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666548423000720 |
| _version_ | 1797390370208743424 |
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| author | Romain Dayer, MD Giacomo De Marco, MD Oscar Vazquez, MD Anne Tabard-Fougère, PhD Blaise Cochard, MD Nathaly Gavira, MD Giorgio Di Laura Frattura, MD Nastassia Guanziroli Pralong, MD Christina Steiger, MD, PhD Dimitri Ceroni, MD |
| author_facet | Romain Dayer, MD Giacomo De Marco, MD Oscar Vazquez, MD Anne Tabard-Fougère, PhD Blaise Cochard, MD Nathaly Gavira, MD Giorgio Di Laura Frattura, MD Nastassia Guanziroli Pralong, MD Christina Steiger, MD, PhD Dimitri Ceroni, MD |
| author_sort | Romain Dayer, MD |
| collection | DOAJ |
| description | Primary spinal infection (PSI) is a generic term covering a heterogeneous group of infections that can affect the vertebral body, intervertebral disks, the content of the medullary cavity, and adjacent paraspinal tissues. Patients’ characteristics can vary significantly, notably according to their age, and some of these characteristics undoubtedly play a primordial role in the occurrence of a PSI and in the type of offending pathogen. Before approaching the subject of laboratory diagnostics, it is essential to define the characteristics of the patient and their infection, which can then guide the physician toward specific diagnostic approaches. This review critically examined the roles and usefulness of traditional and modern laboratory diagnostics in supporting clinicians’ decision-making in cases of pediatric and adult primary spinal infection (PSI). It appears impossible to compare PSIs in children and adults, whether from an epidemiological, clinical, bacteriological, or biological perspective. The recipients are really too different, and the responsible germs are closely correlated to their age. Secondly, the interpretation of traditional laboratory blood tests appears to contribute little guidance for clinicians attempting to diagnose a PSI. Biopsy or needle aspiration for bacterial identification remains a controversial subject, as the success rates of these procedures for identifying causative organisms are relatively uncertain in pediatric populations.Using nucleic acid amplification assays (NAAAs) on biopsy samples has been demonstrated to be more sensitive than conventional cultures for diagnosing PSI. Recent advances in next-generation sequencing (NGS) are particularly interesting for establishing a microbiological diagnosis of a PSI when standard cultures and NAAAs have failed to detect the culprit. We can even imagine that plasma metagenomic NGS using plasma (known as “liquid biopsy”) is a diagnostic approach that can detect not only pathogens circulating in the bloodstream but also those causing focal infections, and thus eliminate the need for source sample collection using costly invasive surgical procedures. |
| first_indexed | 2024-03-08T23:10:44Z |
| format | Article |
| id | doaj.art-bac09919acc7456681e862363fa314d4 |
| institution | Directory Open Access Journal |
| issn | 2666-5484 |
| language | English |
| last_indexed | 2024-03-08T23:10:44Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | North American Spine Society Journal |
| spelling | doaj.art-bac09919acc7456681e862363fa314d42023-12-15T07:26:27ZengElsevierNorth American Spine Society Journal2666-54842023-12-0116100270Laboratory diagnostics for primary spinal infections in pediatric and adult populations: a narrative reviewRomain Dayer, MD0Giacomo De Marco, MD1Oscar Vazquez, MD2Anne Tabard-Fougère, PhD3Blaise Cochard, MD4Nathaly Gavira, MD5Giorgio Di Laura Frattura, MD6Nastassia Guanziroli Pralong, MD7Christina Steiger, MD, PhD8Dimitri Ceroni, MD9Pediatric Orthopedics Unit, Pediatric Surgery Service, Geneva University Hospitals and University of Geneva Rue Willy-Donzé 6, Geneva 1205, SwitzerlandPediatric Orthopedics Unit, Pediatric Surgery Service, Geneva University Hospitals and University of Geneva Rue Willy-Donzé 6, Geneva 1205, SwitzerlandPediatric Orthopedics Unit, Pediatric Surgery Service, Geneva University Hospitals and University of Geneva Rue Willy-Donzé 6, Geneva 1205, SwitzerlandPediatric Orthopedics Unit, Pediatric Surgery Service, Geneva University Hospitals and University of Geneva Rue Willy-Donzé 6, Geneva 1205, SwitzerlandPediatric Orthopedics Unit, Pediatric Surgery Service, Geneva University Hospitals and University of Geneva Rue Willy-Donzé 6, Geneva 1205, SwitzerlandPediatric Orthopedics Unit, Pediatric Surgery Service, Geneva University Hospitals and University of Geneva Rue Willy-Donzé 6, Geneva 1205, SwitzerlandPediatric Orthopedics Unit, Pediatric Surgery Service, Geneva University Hospitals and University of Geneva Rue Willy-Donzé 6, Geneva 1205, SwitzerlandPediatric Orthopedics Unit, Pediatric Surgery Service, Geneva University Hospitals and University of Geneva Rue Willy-Donzé 6, Geneva 1205, SwitzerlandPediatric Orthopedics Unit, Pediatric Surgery Service, Geneva University Hospitals and University of Geneva Rue Willy-Donzé 6, Geneva 1205, SwitzerlandCorresponding author. Service of Pediatric Orthopedics, The Children's Hospital, Geneva University Hospitals, Rue Willy-Donzé 6, Geneva 1205, Switzerland, Tel: +41 22 3724791, Fax: +41 22 3724783.; Pediatric Orthopedics Unit, Pediatric Surgery Service, Geneva University Hospitals and University of Geneva Rue Willy-Donzé 6, Geneva 1205, SwitzerlandPrimary spinal infection (PSI) is a generic term covering a heterogeneous group of infections that can affect the vertebral body, intervertebral disks, the content of the medullary cavity, and adjacent paraspinal tissues. Patients’ characteristics can vary significantly, notably according to their age, and some of these characteristics undoubtedly play a primordial role in the occurrence of a PSI and in the type of offending pathogen. Before approaching the subject of laboratory diagnostics, it is essential to define the characteristics of the patient and their infection, which can then guide the physician toward specific diagnostic approaches. This review critically examined the roles and usefulness of traditional and modern laboratory diagnostics in supporting clinicians’ decision-making in cases of pediatric and adult primary spinal infection (PSI). It appears impossible to compare PSIs in children and adults, whether from an epidemiological, clinical, bacteriological, or biological perspective. The recipients are really too different, and the responsible germs are closely correlated to their age. Secondly, the interpretation of traditional laboratory blood tests appears to contribute little guidance for clinicians attempting to diagnose a PSI. Biopsy or needle aspiration for bacterial identification remains a controversial subject, as the success rates of these procedures for identifying causative organisms are relatively uncertain in pediatric populations.Using nucleic acid amplification assays (NAAAs) on biopsy samples has been demonstrated to be more sensitive than conventional cultures for diagnosing PSI. Recent advances in next-generation sequencing (NGS) are particularly interesting for establishing a microbiological diagnosis of a PSI when standard cultures and NAAAs have failed to detect the culprit. We can even imagine that plasma metagenomic NGS using plasma (known as “liquid biopsy”) is a diagnostic approach that can detect not only pathogens circulating in the bloodstream but also those causing focal infections, and thus eliminate the need for source sample collection using costly invasive surgical procedures.http://www.sciencedirect.com/science/article/pii/S2666548423000720Primary spinal infectionNarrative reviewPediatricAdultDiagnosticsLaboratory |
| spellingShingle | Romain Dayer, MD Giacomo De Marco, MD Oscar Vazquez, MD Anne Tabard-Fougère, PhD Blaise Cochard, MD Nathaly Gavira, MD Giorgio Di Laura Frattura, MD Nastassia Guanziroli Pralong, MD Christina Steiger, MD, PhD Dimitri Ceroni, MD Laboratory diagnostics for primary spinal infections in pediatric and adult populations: a narrative review North American Spine Society Journal Primary spinal infection Narrative review Pediatric Adult Diagnostics Laboratory |
| title | Laboratory diagnostics for primary spinal infections in pediatric and adult populations: a narrative review |
| title_full | Laboratory diagnostics for primary spinal infections in pediatric and adult populations: a narrative review |
| title_fullStr | Laboratory diagnostics for primary spinal infections in pediatric and adult populations: a narrative review |
| title_full_unstemmed | Laboratory diagnostics for primary spinal infections in pediatric and adult populations: a narrative review |
| title_short | Laboratory diagnostics for primary spinal infections in pediatric and adult populations: a narrative review |
| title_sort | laboratory diagnostics for primary spinal infections in pediatric and adult populations a narrative review |
| topic | Primary spinal infection Narrative review Pediatric Adult Diagnostics Laboratory |
| url | http://www.sciencedirect.com/science/article/pii/S2666548423000720 |
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