Role of IS6110-targeted PCR, culture, biochemical, clinical, and immunological criteria for diagnosis of tuberculous meningitis.

Journal article

An open prospective clinical, microbiological, and molecular analysis of a national molecular diagnostic service for tuberculous meningitis (TBM) using an in-house IS6110-targeted PCR for molecular "Fastrack" diagnosis was carried out. Between April 1997 and June 1998. Consecutive cerebrospinal fluid (CSF) samples from 131 patients were assessed. Against a culture on the same sample, PCR had a sensitivity of 75% and a specificity of 94%. Of samples from patients classified as definite or probable TBM cases based on clinical criteria, 81% had raised CSF protein levels and 73% had a lymphocytosis, although 57% of all submitted samples showed a raised lymphocyte count. While only 46% had a CSF glucose level below the normal range, the CSF glucose level was significantly lower (P = 0. 0281) than in cases of meningitis of other etiologies. Levels of tumor necrosis factor alpha were also found to be significantly raised in definite or probable TBM cases (P = 0.028), while adenosine deaminase levels were not. The study showed IS6110-targeted PCR to be a rapid, sensitive, and specific test in routine use for the diagnosis of TBM.

Authors: Caws, M; Wilson, S; Clough, C; Drobniewski, F

• Publication status: Published
• Journal: Journal of clinical microbiology
• Volume: 38
• Issue: 9
• Pages: 3150-3155
• Publication date: 2000-09-01
• EISSN: 1098-660X
• ISSN: 0095-1137
• Language: English
• Keywords: Culture Media; Female; Middle Aged; Tumor Necrosis Factor-alpha; Aged; DNA Transposable Elements; Polymerase Chain Reaction; Prospective Studies; Male; Sensitivity and Specificity; Humans; Adult; Tuberculosis, Meningeal; Glucose; Cerebrospinal Fluid; Adenosine Deaminase; Mycobacterium tuberculosis