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01-11-2016 | Clinical Brief

GeneXpert for Diagnosis of Tubercular Meningitis

Authors: Rakesh Bhatia, Rajeshwar Dayal, Shishir Jindal, Dipti Agarwal, Ankur Goyal

Published in: Indian Journal of Pediatrics | Issue 11/2016

Abstract

Diagnosis of tubercular meningitis (TBM) is difficult in children. The GeneXpert MTB/RIF assay has been recommended by WHO in 2013 to be used in children and in extra pulmonary clinical specimens. The present study was designed to assess the diagnostic utility of GeneXpert in detecting Mycobacterium tuberculosis in cerebrospinal fluid (CSF) in TBM cases and to compare the results with liquid culture BACTEC 460. Thirty four subjects <15 y were diagnosed as TBM based on clinical, CSF and imaging details. Sensitivity of GeneXpert in CSF was 38.24 % as compared to Bactec culture which was only 14.71 % (p 0.0279). To conclude, GeneXpert MTB/RIF test is able to rapidly confirm diagnosis of TBM with higher sensitivity as compared to conventional methods and liquid culture.

Global Tuberculosis Report. Available at: http:/www.who.int/tb/publication/global_report/en. Accessed on 20th July 2015.

Cruz AT, Starke JR. Clinical manifestations of TB in children. Pediatr Respir Rev. 2007;8:107–17.CrossRef

Vadwai V, Boeheme C, Naabeta P, Shetty A, Alland D, Rodrigues C. Xpert MTB/RIF: a new pillar in diagnosis of extrapulmonary tuberculosis? J Clin Microbiol. 2011;49:2540–5.CrossRefPubMedPubMedCentral

Nhu NT. Heemskerk D, Thu do DA, et al. Evaluation of GeneXpert MTB/RIF for diagnosis of tuberculous meningitis. J Clin Microbiol. 2014;52:226–33.

Uria GA, Azcona JM, Middle M, Naik PK, Reddy S, Reddy R. Rapid diagnosis of pulmonary and extrapulmonary tuberculosis in HIV–infected patients. Comparison of LED fluorescent microscopy and the GeneXpert MTB/RIF assay in a district hospital in India. Hindwai Publishing Corporation Tuberculosis Research and Treatment. 2012: Article ID 932862. 4pages.

National Guidelines on Diagnosis and Treatment of Pediatric Tuberculosis. Available at: tbcindia.nic.in /Pediatrics% 20 guidelines. Accessed on 21st November 2015.

Farinha NJ, Razali KA, Holzel H, Morgan G, Novelli VM. Tuberculosis of the central nervous system in children: a 20-year survey. J Infect. 2000;41:61–8.CrossRefPubMed

Ozates M, Kemaloglu S, Gurkan F, Ozkan U, Hosoglu S, Simsek MM. CT of the brain in tubercular meningitis. A review of 289 patients. Acta Radiol. 2000;41:13–7.CrossRefPubMed

Rishi S, Sinha P, Malhotra B, Pal N. A comparative study for the detection of mycobacteria by BACTEC MGIT 960, Lowenstein Jenson media and direct AFB smear examination. Indian J Med Microbiol. 2007;25:383–6.CrossRefPubMed

Title: GeneXpert for Diagnosis of Tubercular Meningitis
Authors: Rakesh Bhatia
Rajeshwar Dayal
Shishir Jindal
Dipti Agarwal
Ankur Goyal
Publication date: 01-11-2016
Publisher: Springer India
Published in: Indian Journal of Pediatrics / Issue 11/2016
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI: https://doi.org/10.1007/s12098-016-2096-0

At a glance: The STEP trials

Springer Medicine

GeneXpert for Diagnosis of Tubercular Meningitis

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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