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[Clinical and epidemiological features of tuberculosis ostitis in BCG-vaccinated children]

N G Kamaeva, Iu P Chugaev, L M Grinberg

    Problemy Tuberkuleza I Boleznei Legkikh
    |March 4, 2009
    PubMed

    Insights

    Pediatric osteitis cases have risen since 2001. Molecular methods confirmed Bacillus Calmette-Guérin (BCG) as the cause in nearly half of the osteitis bone samples, verifying its etiology.

    Area of Science:

    • Pediatric Infectious Diseases
    • Molecular Diagnostics
    • Skeletal Tuberculosis

    Background:

    • Osteitis incidence in children has significantly increased since 2001.
    • Tuberculous osteitis presents distinct clinical and epidemiological features compared to primary pulmonary tuberculosis in infants.

    Purpose of the Study:

    • To investigate the etiology of pediatric osteitis, particularly focusing on the role of Mycobacterium bovis (BCG).
    • To differentiate BCG-related osteitis from other forms of childhood tuberculosis.

    Main Methods:

    • Comparative analysis of clinical and epidemiological data for tuberculous osteitis (n=70) and primary pulmonary tuberculosis (n=60) in infants.
    • Molecular genetic analysis using polymerase chain reaction (PCR) to detect BCG M. bovis strain DNA in intraoperative bone samples and bone destruction foci cultures.

    Main Results:

    • BCG M. bovis strain DNA was identified in 13 (46.4%) intraoperative samples.
    • BCG M. bovis DNA was also detected in 4 samples from bone destruction foci cultures.
    • Isolation of BCG cultures confirmed the findings in bone lesions.

    Conclusions:

    • The detection of BCG M. bovis DNA or isolation of BCG cultures from bone lesions is a key criterion for diagnosing BCG etiology of osteitis.
    • This finding is particularly relevant for pediatric osteitis exhibiting a productive necrotic tuberculosis morphology.
    • Molecular methods provide significant diagnostic value in identifying BCG as the causative agent of pediatric osteitis.

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