Table 2

Results of analyses of specimens from 20 patients with suspected spondylitis or epidural abscess: broad range bacterial PCR, DNA sequencing, bacterial culture, data on operative technique, preoperative antimicrobial treatment, and blood cultures, and final diagnosis

NoInitial diagnosisOperative techniqueSpinal specimenBacterial culture resultPCRSequencing resultHomology (%)aSequence length (nt)aPreoperative antibioticsbBlood culture resultcFinal diagnosis
aThe per cent homology and the length of the overlapping sequence for the best match.
bAn effective antimicrobial treatment against the recognised microbe in the specimen; duration of preoperative antibiotic treatment is given in parentheses.
cThe number of days a positive blood culture result was obtained before the specimen for the PCR assay and culture was taken are given in parentheses. Unless otherwise indicated, blood culture was taken on the same day as the PCR.
dThe sample was interpreted to contain several species if the electropherogram showed strong signals but multiple overlapping peaks in some locations.
eNegative result.
fThe patient received ofloxacin.
gThe patient received ceftriaxone and metronidazole.
hThe patient received trimethoprim prophylaxis for urinary tract infection.
iAseptic spondylitis was diagnosed as one component of an autoimmune disorder of unknown origin, as described in ref29.
jSequencing failure was assumed if the sequencing signals reported by the instrument were weak.
nt, nucleotides; PCR, polymerase chain reaction.
1SpondylitisOpen biopsyPus Staph aureus +Staphylococcus sp, probably several speciesd86.3164Yes (8 days)Staph aureus (−8 days)Spondylitis and epidural abscess
2Epidural abscessOpen biopsyPuse+Staphylococcus sp94.7216Yes (15 days)Staph aureus (−15 days)Epidural abscess
3SpondylitisOpen biopsyBone and disc+ Staph aureus 98.6441Yes (12 days)Staph aureus (−14 days)Spondylitis
4Postoperative spondylodiscitisOpen biopsyPus+ Str intermedius 98.1423Yes (13 days)Not donePostoperative spondylodiscitis
5Vertebral tumourOpen biopsyBone+ Str mitis/gordonii/ oralis/peroris 100418Yes (4 days)Not doneSpondylitis
6SpondylitisPuncturePus+Pseudomonas sp97.4268Yes (2 days)Str mitis (−3 days)Spondylitis and infective endocarditis
7SpondylitisStereotactic biopsyBone Staph aureus No Staph aureus Spondylitis
8Postoperative epidural abscessOpen biopsyPus Pseudomonas aeruginosa No Pseudomonas aeruginosa Postoperative spondylodiscitis and epidural abscess
9Vertebral tumourOpen biopsyBoneYesf (4 days)Spondylitis
10Spondylitis and epidural abscessOpen biopsyBoneNoSpondylitis
11Epidural abscessOpen biopsyBoneYesg (10 days)Not doneSpondylitis
12Postoperative spondylodiscitis and epidural abscessOpen biopsyDiscNoPostoperative spondylodiscitis
13SpondylitisOpen biopsyBoneYeshAseptic spondylitisi
14SpondylitisOpen biopsyBoneNoNot doneAseptic spondylitis
15SpondylitisOpen biopsyBoneNoAseptic spondylitis
16SpondylitisOpen biopsyBoneYes (one dose)Lymphoma
17SpondylitisOpen biopsyBoneYes (8 days)Lymphoma
18Vertebral tumour or infectionOpen biopsyBone+FailurejYes (one dose)Not doneLymphoma
19Vertebral tumour or infectionOpen biopsyEpidural tumourYes (one dose)Not doneLymphoma
20Vertebral tumour or infectionOpen biopsyEpidural tumourYes (one dose)Not donePlasma cell granuloma