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

• Published in: Epidemiology and infection Vol. 145; no. 10; pp. 2152 - 2160
• Main Authors: PEGHIN, M., RODRIGUEZ-PARDO, D., SANCHEZ-MONTALVA, A., PELLISÉ, F., RIVAS, A., TORTOLA, T., AGUILAR, J., ALMIRANTE, B., PIGRAU, C.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.07.2017
• Subjects: Adult; Aged; Biopsy; Clinical medicine; Compression; Drugs; Emigrants and Immigrants; Emigration and Immigration; Epidemiology; Female; Hospitals; Humans; Immigration; Incidence; Infectious diseases; Joint surgery; Male; Medicine; Microbiology; Middle Aged; Mycobacterium tuberculosis - isolation & purification; Neurological complications; Observational studies; Original Papers; Patients; Retrospective Studies; Society; Spain - epidemiology; Studies; Surgery; Tuberculosis; Tuberculosis, Spinal - epidemiology; Tuberculosis, Spinal - ethnology; Tuberculosis, Spinal - microbiology; Vertebrae; Spain; immigration; spinal tuberculosis; Pott disease; tuberculosis; GeneXpert MTB/RIF
• ISSN: 0950-2688; 1469-4409; 1469-4409
• DOI: 10.1017/S0950268817000863

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.