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Comparative evaluation of IS6110 and protein antigen b PCR in cerebrospinal fluid for rapid diagnosis of tuberculous meningitis in children.
Journal of Medical Microbiology ( IF 2.4 ) Pub Date : 2020-07-01 , DOI: 10.1099/jmm.0.001220
Sikha Agarwal 1 , Arushi Gahlot Saini 1 , Sumeet Dhawan 1 , Alka Khadwal 2 , Kusum Sharma 3 , Pratibha Singhi 1
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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%。
更新日期:2020-08-20
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