Skip to main content

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