Authors: Huang, H-J.; Xiang, D-R.; Sheng, J-F.; Li, J.; Pan, X-P.; Yu, H-Y.; Sheng, G-P.; Li, L-J.

Source: The International Journal of Tuberculosis and Lung Disease, Volume 13, Number 6, June 2009 , pp. 749-754(6)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: The prognosis of tuberculous meningitis (TBM) is linked to early diagnosis and prescription of adequate treatment.

OBJECTIVE: To evaluate the efficacy of the rpoB nested polymerase chain reaction (PCR) and sequencing assay to detect and identify Mycobacterium tuberculosis complex (MTC) strains and strains resistant to rifampicin (RMP) in cerebrospinal fluid specimens (CSF) from patients with highly suspected TBM.

DESIGN: Retrospective blinded hospital-based study.

RESULTS: rpoB nested PCR and sequencing assay detected MTC in 31/36 CSF specimens from 16 patients with clinically suspected TBM. All of the control CSF specimens from 25 patients with non-TBM showed negative results. One of the 16 patients had a mutation at codon C526G as compared to the rpoB sequences in GenBank. This corresponds to a diagnostic sensitivity of 86% (95%CI 71-95) and a specificity of 100% (95%CI 86-100).

CONCLUSION: Our results suggest that rpoB nested PCR and sequencing assay can detect MTC and simultaneously determine its RMP susceptibility in CSF from patients with highly suspected TBM.

Keywords: tuberculous meningitis; rpoB gene; diagnosis; sensitivity; specificity

Document Type: Regular paper

Affiliations: 1: State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China

Publication date: 2009-06-01

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• The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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