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Journal article

Xpert MTB/RIF ultra for the diagnosis of tuberculous meningitis: a small step forward

Abstract:
The delayed diagnosis of tuberculous meningitis (TBM) leads to poor outcomes, yet the current diagnostic methods for identifying Mycobacterium tuberculosis in cerebrospinal fluid (CSF) are inadequate. The first comparative study of the new GeneXpert MTB/RIF Ultra (Xpert Ultra) for TBM diagnosis suggested increased sensitivity of Xpert Ultra. Two subsequent studies have shown Xpert Ultra has improved sensitivity, but has insufficient negative predictive value to exclude TBM. Collecting and processing large volumes of CSF for mycobacterial testing are important for optimal diagnostic test performance. But clinical, radiological, and laboratory parameters remain essential for TBM diagnosis and empiric therapy is often needed. We therefore caution against the use of Xpert Ultra as a single diagnostic test for TBM; it cannot be used to “rule out” TBM.
Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1093/cid/ciaa473

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
ORCID:
0000-0002-2858-2087


More from this funder
Grant:
106680/B/14/Z milestone CORE
200205/Z/15/Z


Publisher:
Oxford University Press
Journal:
Clinical Infectious Diseases More from this journal
Volume:
71
Issue:
8
Pages:
2002-2005
Publication date:
2020-06-16
Acceptance date:
2020-04-22
DOI:
EISSN:
1537-6591
ISSN:
1537-6591
Pmid:
32543658


Language:
English
Keywords:
Pubs id:
1113869
Local pid:
pubs:1113869
Deposit date:
2020-07-06

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