Improved sensitivity of nucleic acid amplification for rapid diagnosis of tuberculous meningitis

Journal of Clinical Microbiology
Isik Somuncu JohansenVibeke Østergaard Thomsen

Abstract

Early diagnosis of tuberculous meningitis (TBM) is essential for a positive outcome; but present microbiological diagnostic techniques are insensitive, slow, or laborious. We evaluated the standard BDProbeTec ET strand displacement amplification method (the standard ProbeTec method) for the detection of Mycobacterium tuberculosis complex organisms in parallel with the ProbeTec method with a modified pretreatment procedure with 101 prospectively collected cerebrospinal fluid specimens from 94 patients with suspected TBM. By the modified method, the sample-washing step was omitted. A definitive diagnosis was attained by culture. Thirteen specimens from 12 patients were culture positive for M. tuberculosis complex organisms; three specimens (23%) were microscopy positive for acid-fast bacilli. Among the culture-positive specimens, the standard ProbeTec method was positive for 8 (61.5%) and the modified assay was positive for 10 (76.9%). The overall specificity by both procedures was 98.8% compared to the results of culture. After discrepancy analysis, conducted by reviewing the patients' previous laboratory data, the specificity increased to 100%. If the cutoff value for respiratory specimens was adjusted from the recommended valu...Continue Reading

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Citations

Nov 12, 2005·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·V C C ChengK Y Yuen
Apr 11, 2008·Clinical Microbiology Reviews·R Bryan RockPhillip K Peterson
Apr 13, 2011·Clinical Microbiology Reviews·Linda M ParsonsJohn Nkengasong
Jun 6, 2008·Journal of Clinical Microbiology·P KumarH K Prasad
Feb 14, 2009·Current Problems in Pediatric and Adolescent Health Care·Jennifer Lighter, Mona Rigaud
Nov 9, 2006·Advances in Pediatrics·Dwight A Powell, W Garrett Hunt
Apr 20, 2005·Clinics in Chest Medicine·Daniel Brodie, Neil W Schluger
Feb 8, 2014·Diagnostic Microbiology and Infectious Disease·Regan S SolomonsAnne M van Furth

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