Evaluation of GeneXpert MTB/RIF for Diagnosis of Tuberculous Meningitis

摘要: Tuberculous meningitis (TBM) is the most severe form of tuberculosis. Microbiological confirmation rare, and treatment often delayed, increasing mortality morbidity. The GeneXpert MTB/RIF test was evaluated in a large cohort patients with suspected tuberculous meningitis. Three hundred seventy-nine presenting to Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam, between 17 April 2011 31 December 2012 were included study. Cerebrospinal fluid samples tested by Ziehl-Neelsen smear, mycobacterial growth indicator tube (MGIT) culture, Xpert MTB/RIF. Rifampin (RIF) resistance results confirmed an MTBDR-Plus line probe assay all positive cultures phenotypic MGIT drug susceptibility testing. Overall, 182/379 (48.0%) diagnosed Sensitivities Xpert, culture among TBM 59.3% (108/182 [95% confidence interval {CI}, 51.8 66.5%]), 78.6% (143/182 CI, 71.9 84.3%]) 66.5% (121/182 59.1 73.3%]), respectively. There one false-positive (99.5% specificity). Four cases RIF (4/109; 3.7%) identified which 3 be multidrug-resistant (MDR) negative. rapid specific diagnosis addition vortexing step sample processing increased sensitivity 20% (P = 0.04). Meticulous examination smear from volume cerebrospinal (CSF) remains sensitive technique but not practical laboratories. represents significant advance early this devastating condition.