Can Bacterial Infection by Low Virulent Organisms Be a Plausible Cause for Symptomatic XXXX ? A Systematic Review.

@entity1 @entity66 @entity1797 @entity2348 @entity5478 @entity281 @entity615 @entity179 @entity158 @entity614
STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To review and assess the current evidence from the literature on the potential association between @entity281 with the development of symptomatic @entity179 . SUMMARY OF BACKGROUND DATA: The potential relationship between @entity281 - and @entity1797 remains controversial, with contradictory evidence available in the literature. Several studies have demonstrated the presence of infected extruded nucleus tissue from first-time disc herniations, implicating the role of disc microbial infection as a pathway for @entity1797 . In contrast, other studies reported very low prevalence of @entity2348 in samples from @entity1 with sciatica, quoting contamination as the predominant source. To summarize the available evidence to date, a systematic review and meta-analysis was conducted. METHODS: A comprehensive search from 6 electronic databases was performed for studies investigating the potential relationship between @entity281 as a cause for @entity179 and @entity615 or @entity614 . Random-effects meta-analysis of proportions and odds ratio with 95% confidence intervals was used to pool the available evidence. RESULTS: Nine relevant studies involving 602 @entity1 with @entity179 or @entity158 were identified. From 6 studies supporting the role of infection in the pathophysiology of @entity1797 , the pooled infection prevalence was 45.2% (34.5%-56.0%). Overall pooled prevalence in all studies was 36.2% (24.7%-47.7%). Proportion of disc @entity281 was higher in @entity1 with symptomatic @entity66 than in @entity1 without (37.4% vs. 5.9%; odds ratio, 6.1; 95% confidence intervals, 1.426-25.901). The majority of @entity281 were due to @entity5478 in 59.6% (43.2%-76.1%). CONCLUSION: From the limited evidence available, the possibility that @entity281 may be linked with @entity1797 should not be ruled out. There is a need to investigate this further through larger, adequately powered multi-institutional studies with contaminant arm to control for specimen contamination. LEVEL OF EVIDENCE: 2.
