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The changing epidemiology of spinal tuberculosis: the influence of international immigration in Catalonia, 1993-2014.

The changing epidemiology of spinal tuberculosis: the influence of international immigration in Catalonia, 1993-2014.
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Peghin M, Rodriguez-Pardo D, Sanchez-Montalva A, Pellisé F, Rivas A, Tortola T, Aguilar J, Almirante B, Pigrau C,


Peghin M, Rodriguez-Pardo D, Sanchez-Montalva A, Pellisé F, Rivas A, Tortola T, Aguilar J, Almirante B, Pigrau C, (click to view)

Peghin M, Rodriguez-Pardo D, Sanchez-Montalva A, Pellisé F, Rivas A, Tortola T, Aguilar J, Almirante B, Pigrau C,

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Epidemiology and infection 2017 05 18145(10) 2152-2160 doi 10.1017/S0950268817000863
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.

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