Correlation of clinical, laboratory and drug susceptibility profiles in 176 patients with culture positive TBM in a tertiary neurocare centre

Kumar, Kavitha; Giribhattanavar, Prashant; Chandrashekar, N.; Patil, Shripad A.

doi:10.1016/j.diagmicrobio.2016.09.018

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…The CSF samples of definite TBM are rare due to the difficulty to detect MTb in the CSF. In our study, the rate of CSF culture positivity for MTb was 29%; considering the groups with definite and probable TBM, this result was in accordance with that of the previous studies 27,39,40 . TBM accounts for 5% of all Tb cases; among which, 1.25% account for culture-proven TBM cases.…”

Section: Discussionsupporting

confidence: 92%

Diagnostic characteristics of Xpert MTB/RIF assay for the diagnosis of tuberculous meningitis and rifampicin resistance in Southern Brazil

Almeida

Kussen

Cogo

et al. 2020

Arq. Neuro-Psiquiatr.

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Background: The timely diagnosis of tuberculous meningitis (TBM) is challenging. Molecular diagnostic tools are necessary for TBM, particularly in low- and middle-income countries. Objectives: We aimed to calculate the diagnostics characteristics of Xpert MTB/RIF for the detection of Mycobacterium tuberculosis in the cerebrospinal fluid (CSF) and the frequency of rifampicin (RIF)-resistance in the CSF samples. Methods: A total of 313 consecutive CSF samples were studied and categorized into TBM definite, probable, possible, or not TBM cases based on the clinical, laboratory, and imaging data. Results: For the definite TBM cases (n=7), the sensitivity, specificity, efficiency, and positive likelihood ratio were 100, 97, 97, and 38%, respectively. However, for the TBM definite associated with the probable cases (n=24), the sensitivity decreased to 46%. All CSF samples that were Xpert MTB/RIF-positive were RIF susceptible. Conclusion: Xpert MTB/RIF showed high discriminating value among the microbiology-proven TBM cases, although the values for the probable and possible TBM cases were reduced. Xpert MTB/RIF contributes significantly to the diagnosis of TBM, mainly when coupled with the conventional microbiological tests and clinical algorithms.

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Section: Discussionsupporting

confidence: 92%

Diagnostic characteristics of Xpert MTB/RIF assay for the diagnosis of tuberculous meningitis and rifampicin resistance in Southern Brazil

Almeida

Kussen

Cogo

et al. 2020

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…Although bacilli culture is precise and reliable, it is time consuming, which could cause the loss of treatment time [ 6 ]. Current TBM clinical diagnosis relies on the clinical manifestations, CSF examination, imaging examinations and response to tentative anti-TB therapy [ 7 ]. In recent years, the non-standard applications of antibiotics and steroids may temporarily relieve TBM in some patients [ 10 ], which should also interfere the diagnosis of TBM.…”

Section: Discussionmentioning

confidence: 99%

“…The mean detection time is significantly shorten after MGIT 960 culture (2-4 weeks). Therefore, MGIT 960 culture has been one of the most effective methods in the pathogen detection of TB [ 7 , 9 ]. In the present study, MGIT 960 culture had the sensitivity of only 12.79% (22/172) in the diagnosis of TBM, which was yet still higher than that of acid-fast staining (2.91%, 5/172).…”

Section: Discussionmentioning

confidence: 99%

The application of IS6110-baced loop-mediated isothermal amplification (LAMP) in the early diagnosis of tuberculous meningitis

Sun

Yan

et al. 2017

Oncotarget

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Here, we evaluated the potential activity of rapid Mycobacterium tuberculosis detection with loop-mediated isothermal amplification (LAMP), for the early diagnosis of tuberculous meningitis (TBM). Patients with suspected TBM from January 2014 to December 2015 were reviewed retrospectively. The cerebrospinalfluid(CSF) was collected. Acid-fast bacillus (AFB) staining, MGIT 960 culture, real-time fluorescent quantitative polymerase chain reaction (RTFQ PCR) and LAMP were performed. A total of 200 patients were included in the study. Of which, 172 of them were diagnosed with TBM (86.00%). The sensitivities of AFB staining, MGIT 960 culture, LAMP and RTFQ PCR for TBM diagnosis were 2.91% (5/172), 12.79% (22/172), 43.02% (74/172), and 34.30% (59/172), respectively. The sensitivity of LAMP for TBM was significantly higher than those of AFB staining and MGIT960 culture (χ2 = 75.11, P < 0.001; χ2 = 43.88, P = 0.002). LAMP's sensitivity was however comparable to RTFQ PCR assay (χ2 = 2.08, P = 0.130). The specificity, positive predictive value and negative predictive value of LAMP in the diagnosis of TBM were 92.86% (26/28), 97.37% (74/76) and 20.97 % (26/124), respectively. The overall consistency between LAMP and RTFQ PCR in the diagnosis of TBM was 88.5% (177/200), with Kappa value of 0.870. The consistency between LAMP and MGIT960 culture was 71% (142/200), with Kappa value of 0.730. Among all the methods, LAMP had high sensitivity, specificity and positive predictive value, showing high consistency with MGIT960 culture and RTFQ PCR.

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Management of complex tuberculosis cases: a focus on drug-resistant tuberculous meningitis

Garg

Rizvi

Malhotra

et al. 2018

Expert Review of Anti-infective Therapy

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Correlation of clinical, laboratory and drug susceptibility profiles in 176 patients with culture positive TBM in a tertiary neurocare centre

Cited by 7 publications

References 10 publications

Diagnostic characteristics of Xpert MTB/RIF assay for the diagnosis of tuberculous meningitis and rifampicin resistance in Southern Brazil

Diagnostic characteristics of Xpert MTB/RIF assay for the diagnosis of tuberculous meningitis and rifampicin resistance in Southern Brazil

The application of IS6110-baced loop-mediated isothermal amplification (LAMP) in the early diagnosis of tuberculous meningitis

Management of complex tuberculosis cases: a focus on drug-resistant tuberculous meningitis

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