Table 6 Methods used for bacteria identification and to minimize contamination and prevalence, and type of bacteria identified
From: Could low grade bacterial infection contribute to low back pain? A systematic review
Studies and design | Biopsy: Method, site and no. of specimens | Methods to minimize contamination | Duration of culturing biopsy material | Bacteria identification methods | Culture-positive samples (n, %) | Organisms identified in positive cultures (%) | Subsequently made generic analysis of P. acnes species | Quality score |
|---|---|---|---|---|---|---|---|---|
Albert [2] Cross-sectional | Open | All scalpels flamed before use as extra precaution | 7 days with subsequent 1 day of subculture | Culture, PCR | 28/61 (46%) | P. acnes : 86% | Analytical profile index biochemical analysis using Rapid ID 32A kit (bioMerieux) and PCR amplification of 16S rDNA | 78 |
Disc material | Gram-positive cocci: 14% | |||||||
Five specimens | ||||||||
Coagulase-negative (CN) staphylococci: 7% | ||||||||
Stirling [14] Cross-sectional | Open | Stringent aseptic precautions taken to minimise risk of contamination | 7 days | Culture, serology | 19/36 (53%) | P. acnes : 84% | Microscopy of Gram-stained smears of tissue samples | 78 |
Disc material | CN staphylococci: 11% | |||||||
Not stated | ||||||||
Corynebacterium propinquum: 5% | ||||||||
Stirling [17] Cross-sectional | Open | Not stated | 7 days | Culture, serology | 76/207 (37%) | P. acnes : 64% | Microscopy of Gram-stained smears of tissue samples | 56 |
Disc material | CN staphylococci: 14% | |||||||
Not stated | Propionibacteria: 10.5% | |||||||
Agarwal [16] Cross-sectional | Open | Disc material retained in a closed sterile sample cup | 5 days | Culture | 10/52 (19.2%) | P. acnes : 70% | Not stated | 78 |
Disc material | Peptostreptococci: 10% | |||||||
Not stated | Staphylococci aureus: 10% | |||||||
CN staphylococci: 10% | ||||||||
Arndt [9] Cross-sectional | Open | Disc structures stored in sterile syringes filled with physiological saline solution, care was taken to avoid contamination during conditioning process of biopsy | Blood agar, Drigalski agar: 24 h | Culture | 40/83 (48.2%) | P. acnes : 45% | Not stated | 67 |
Disc material | Polyvitex chocolate agar: 4 days | CN staphylococci: 40% | ||||||
1 in 1st 25 disk replacements; 3 in following 58 | Blood agar supplemented with hemin: 5 days | CN bacilli: 7.5% | ||||||
Peptone glucose yeast broth: 10 days | ||||||||
Bactec Peds Plue bottle with fructooligosaccharide nutritional supplement: 7 days | ||||||||
Coscia [11] Cross-sectional | Open | Specimens were obtained sterilely immediately at the time of surgical excision | Cultured using extended duration incubation techniques (repeated subcultures up to several weeks duration) | Culture | 16/30 (53.3%) | Staphylococcus: 36% | Not stated | 78 |
Disc material | P. acnes : 18% | |||||||
Not stated | ||||||||
Ben-Galim [10] Cross-sectional | Open | Samples are processed and cultured intraoperatively under stringent, sterile operating theatre conditions, culture mediums were warmed to room temperature before each operation | 2 weeks | Culture | 2/30 (6.7%) | CN staphylococci: 100% | Not stated | 67 |
Disc material | ||||||||
Four pieces (disc material dissected into four pieces) | ||||||||
Fritzell [12] Cross-sectional | Open | Samples taken openly (no needle), all operations except for one were performed through a microscope with use of bipolar diathermy, assuring a very ‘dry’ operation field | Not applicable | PCR | (PCR) | (PCR) | Not stated | 67 |
Disc material | 2/10 (20%) | Bacillus cereus: 50% | ||||||
Two – one from annulus fibrosus and one from nucleus pulposus | Citrobacterbraaki/freundi: 50% | |||||||
Carricajo [13] Cross-sectional | Open | Obtained under aseptic conditions | One horse-blood agar, two chocolate PolyVitex agar: 10 days | Culture | 12/54 (22%) | P. acnes : 17% | Not stated | 67 |
One Schaedler medium: 20 days | ||||||||
Disc material, muscle, ligamentum flavum | Anaerobic streptococci: 8% | |||||||
Three – muscle, ligamentum flavum, herniated intervertebral discs | ||||||||
Wedderkopp [15] Cross-sectional | Needle | Obtained with sterile technique | 2 weeks | Culture | 2/24 (8.3%) | Staph epidermidis: 50% | Not stated | 67 |
CN staphylococci: 50% | ||||||||
Vertebral body | ||||||||
One – at site of Modic Type 1 change |