Treatment of Bone and Joint Tuberculosis in France: A Multicentre Retrospective Study

Aurelie Guillouzouic (1) , Claire Andrejak (2, 3) , Olivia Peuchant (4) , Genevieve Hery-Arnaud (5) , Farida Hamdad (2) , Philippe Lanotte (6, 7) , Benjamin Gaborit (8) , Louis Bernard (9, 10) , Pascale Bemer (1, 11)

1 CHU Nantes - Centre Hospitalier Universitaire de Nantes
2 CHU Amiens-Picardie
3 AGIR - Agents infectieux, résistance et chimiothérapie - UR UPJV 4294
4 CHU Bordeaux
5 GGB - Génétique, génomique fonctionnelle et biotechnologies (UMR 1078)
6 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
7 UMR ISP - Infectiologie et Santé Publique
8 EA 3826 - Thérapeutiques cliniques et expérimentales des infections (EA 3826)
9 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
10 CRIOGO - Centre de référence en infections ostéo-articulaires du grand-ouest [Rennes]
11 MiHAR - Microbiotes, Hôtes, Antibiotiques et Résistances bactériennes (MiHAR)

Background: Nine percent of all cases of tuberculosis are bone and joint tuberculosis (BJTB). BJTB occurs in two main forms: spinal (STB) and extraspinal (ESTB). The aim of this study was to compare STB with ESTB in terms of diagnosis, treatment and outcomes. Methods: We collected demographic, clinical, microbiological, treatment duration and outcome data for patients with BJTB in a retrospective multicentre study over a 17-year period. Results: Of the 116 patients included in the study, 69 (59.5%) had STB and 47 (40.5%) had ESTB. The median age was higher in the ESTB group. There were significantly more foreign-born patients in the STB group. The median time for diagnosis was longer for ESTB (6 months) than STB (4 months) (p= 0.017). Magnetic resonance imaging was highly reliable for the diagnosis. Direct examination and histology allowed the diagnosis to be made in more than 80% of cases. The median treatment duration of 12 months, regardless of the type of BJTB, was longer than recommended. A favourable outcome was achieved in 91.9% of cases. Conclusion: The management of BJTB remains challenging. An earlier diagnosis should be more effective, reducing the total duration of treatment and leading to better tolerance.

Mots clés: spinal tuberculosis; extraspinal tuberculosis; bone and joint tuberculosis; diagnosis; treatment duration

Domaines: Sciences du Vivant [q-bio]

Aurelie Guillouzouic, Claire Andrejak, Olivia Peuchant, Genevieve Hery-Arnaud, Farida Hamdad, et al.. Treatment of Bone and Joint Tuberculosis in France: A Multicentre Retrospective Study. Journal of Clinical Medicine, 2020, 9 (8), pp.2529. ⟨10.3390/jcm9082529⟩. ⟨hal-03591322⟩