{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T18:28:15Z","timestamp":1746124095609,"version":"3.37.3"},"reference-count":26,"publisher":"Asian Spine Journal (ASJ)","issue":"3","license":[{"start":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T00:00:00Z","timestamp":1684281600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["asianspinejournal.org"],"crossmark-restriction":true},"short-container-title":["Asian Spine J"],"published-print":{"date-parts":[[2023,6,30]]},"abstract":"<jats:p>Study Design: Prospective study.Purpose: To evaluate the utility of whole genome sequencing (WGS) in drug resistance testing, lineage of the organisms, and organism- related factors responsible for bacilli settling in the spine.Overview of Literature: The workstream for the diagnosis of tuberculosis (TB) involves isolation and culture of the organism and drug resistance testing using phenotypic methods. Xpert MTB\/RIF Ultra is a genetic-based method that detects for &lt;i&gt;Mycobacterium tuberculosis&lt;\/i&gt; DNA in the &lt;i&gt;rpoB&lt;\/i&gt; gene. Meanwhile, WGS is a newer genetic-based method that assesses the whole genome of the bacterium. Very few studies have reported the use of WGS for extrapulmonary TB. Herein, we used WGS to diagnose spinal TB.Methods: Tissues from 61 patients undergoing surgery for spinal TB underwent histologic examination, Xpert MTB\/RIF Ultra, and culture and sensitivity testing. DNA from the cultured bacteria was sent for WGS. The test bacterial genome was compared to a reference strain of pulmonary TB.Results: Acid-fast bacilli were observed in 9\/58 specimens. Meanwhile, histology confirmed TB in all the patients. Bacilli were cultured in 28 patients (48.3%), and the average time to culture was 18.7 days. Xpert MTB\/RIF Ultra was positive in 47 patients (85%). WGS was performed in 23 specimens. Overall, 45% of the strains belonged to lineage 2 (East Asian). There was one case of multidrug- resistant TB and two cases of non-tuberculous mycobacteria on WGS. We could not confirm any genomic difference between pulmonary and spinal TB strains.Conclusions: Xpert MTB\/RIF Ultra of tissues or pus is the investigation of choice when diagnosing spinal TB. Meanwhile, WGS can diagnose multidrug-resistant TB and non-tuberculous mycobacteria more accurately. No mutations were identified in spinal and pulmonary TB bacteria.<\/jats:p>","DOI":"10.31616\/asj.2022.0247","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T04:04:47Z","timestamp":1684296287000},"page":"511-517","update-policy":"https:\/\/doi.org\/10.31616\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["New Horizons in the Diagnosis of Tuberculosis of the Spine: The Role of Whole Genome Sequencing"],"prefix":"10.31616","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7564-3308","authenticated-orcid":true,"given":"Mthunzi","family":"Ngcelwane","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6983-1636","authenticated-orcid":true,"given":"Shaheed 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polymerase chain reaction for spinal tuberculosis: an accurate and rapid diagnostic test","author":"Held","year":"2014"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2019.00309"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1080\/20477724.2016.1214350"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1053\/j.semss.2015.07.006"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00666-18"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2017.07.007"},{"key":"ref17","first-page":"E806","volume-title":"Multidrug-resistant tuberculosis of the spine: is it the beginning of the end?: a study of twenty-five culture proven multidrug-resistant tuberculosis spine patients","author":"Pawar","year":"2009"},{"key":"ref18","first-page":"100","volume-title":"Drug-resistant spinal tuberculosis","author":"Jain","year":"2018"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2020.01444"},{"key":"ref20","first-page":"905","volume-title":"Tuberculosis of the spine: a fresh look at an old disease","author":"Jain","year":"2010"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.4103\/1947-2714.115775"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2017.11.3.405"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jctube.2019.100115"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2017.08.054"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir788"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.02167-08"}],"container-title":["Asian Spine 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