Introduction. Childhood tuberculosis meningitis is a severe form of tuberculosis with high morbidity and mortality. The diagnosis is frequently missed and delayed due to lack of sensitive tests like acid-fast bacilli (AFB) smear and delayed results by culture. Aims. To compare the role of IS6110 and protein antigen b PCR in cerebrospinal fluid (CSF) for rapid diagnosis of tuberculous meningitis (TBM) in children. Methodology. Forty-five cases of TBM and 20 controls were enrolled in this prospective study. Results. The mean ages of cases and controls were 4.2±0.5 years and 4.5±0.7 years, respectively. In the TBM group, two-thirds of the children were <4 years of age, and 62 % were males. Sensitivities of AFB smear examination, Löwenstein–Jensen (LJ) medium and bactenecin (BACTEC) culture in cases were 4.4, 0 and 2.2%, respectively. The protein antigen b PCR was most sensitive as it was positive in 35 (77.8 %) of TBM patients; IS6110 PCR was positive in 27 (60 %) patients. Both PCR-based tests had higher positivity than conventional tests and BACTEC culture. No significant difference was seen between the PCR tests. Excellent agreement was observed between both PCR-based tests as they were concordant for 26 positive samples and 35 negative samples. Conclusion. Protein b PCR is a sensitive and rapid method for the diagnosis of TBM (sensitivity 77.8 %). Both PCRs were more sensitive than smear, LJ and BACTEC. The specificity of both PCR was 100 %.

中文翻译：

---

脑脊液中IS6110和蛋白抗原b PCR的比较评估，可快速诊断儿童结核性脑膜炎。

介绍。儿童结核性脑膜炎是一种严重的结核病，具有较高的发病率和死亡率。由于缺乏诸如抗酸杆菌（AFB）涂片等敏感测试以及培养结果的延迟，该诊断经常被错过和延迟。目的 比较IS6110和蛋白抗原b PCR在脑脊液（CSF）对儿童结核性脑膜炎（TBM）的快速诊断中的作用。方法。该前瞻性研究纳入了45例TBM病例和20例对照。结果。病例和对照的平均年龄分别为4.2±0.5岁和4.5±0.7岁。在TBM组中，三分之二的孩子小于4岁，而62％是男性。AFB涂片检查，Löwenstein-Jensen（LJ）培养基和细菌素（BACTEC）培养的敏感性分别为4.4％，0％和2.2％。蛋白抗原b PCR最敏感，因为它在35例TBM患者中为阳性（77.8％）；IS6110 PCR在27（60％）位患者中呈阳性。两种基于PCR的检测均比常规检测和BACTEC培养具有更高的阳性率。在PCR测试之间未观察到显着差异。在两个基于PCR的测试之间观察到极好的一致性，因为它们对于26个阳性样品和35个阴性样品是一致的。结论。蛋白b PCR是诊断TBM的灵敏且快速的方法（灵敏度为77.8％）。两种PCR均比涂片，LJ和BACTEC敏感。两种PCR的特异性均为100％。