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geneXpert in tuberculous meningitis

Renu Gupta, Puneet Talwar, Pumanshi Talwar, Sarbjeet Khurana, Suman Kushwaha, Nupur Jalan, Rajeev Thakur
BACKGROUND: Numerous in-house and commercial nucleic acid amplification tests (NAAT) have been evaluated using variable reference standards for diagnosis of TBM but their diagnostic potential is still not very clear. METHODS: We conducted a meta-analysis to assess the diagnostic accuracy of different NAAT based assays for diagnosing TBM against 43 data sets of confirmed TBM (n=1066) and 61 data sets of suspected TBM (n=3721) as two reference standards. The summary estimate of the sensitivity and the specificity were obtained using the bivariate model...
May 11, 2018: Journal of Infection
Nguyen T H Mai, Guy E Thwaites
PURPOSE OF REVIEW: Tuberculous meningitis is a devastating infection that is hard to diagnose and treat. We have reviewed tuberculous meningitis original research published within the past 18 months, selecting studies which we consider have most advanced knowledge. RECENT FINDINGS: We review advances in diagnostic methods, anti-tuberculosis chemotherapy, and the common complications of tuberculous meningitis. New commercial molecular diagnostic tests, such as GeneXpert MTB/RIF, have an important role in tuberculous meningitis diagnosis, but as with all other available tests, they lack sensitivity and cannot rule out the disease...
February 2017: Current Opinion in Infectious Diseases
Z F Chen, H L Lao, X H Li, J Wang, Q Chen, Z X Wang, D C Wang
OBJECTIVE: To explore the application value of GeneXpert MTB/RIF for detection of extra-pulmonary tuberculosis and resistance to rifampin. METHODS: A total of 150 samples were collected, including 33 needle aspirates from lymphoid tuberculosis, 23 needle aspirates from spinal tuberculosis, 49 from tuberculous pleural effusions, 24 from cerebrospinal fluid of tuberculous cephalomeningitis, and 21 urinary sediment samples from renal tuberculosis. Smear microscopy, mycobacterium tuberculosis culture and the MTB/RIF method were used to examine these samples and their positive rates were compared...
July 2016: Chinese Journal of Tuberculosis and Respiratory Diseases
Nathan C Bahr, Suzaan Marais, Maxine Caws, Reinout van Crevel, Robert J Wilkinson, Jaya S Tyagi, Guy E Thwaites, David R Boulware
Tuberculous meningitis (TBM) is the most severe form of tuberculous with substantial mortality. In May 2015, 54 researchers from 10 countries met in Da Lat, Vietnam, to discuss advances in TBM. Among the attendees were researchers involved in pivotal studies on the use of Xpert MTB/Rif for TBM diagnosis. Attendees discussed the 2014 World Health Organization strong recommendation favoring the use of Xpert "in preference to conventional microscopy and culture as the initial diagnostic test for cerebrospinal fluid (CSF) if the sample volume is low or if additional specimens cannot be obtained to make a quick diagnosis...
May 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Poojan Shrestha, Buddhi Paudyal, Buddha Basnyat
Tuberculous meningitis (TBM) remains the most dangerous form of tuberculosis with high mortality and potential complications. The prompt diagnosis and treatment of this condition remains a key for better prognosis. A 39-year-old woman presented with severe headache, fever, nausea and vomiting, with a history of headache for a month. On examination, confusion, neck rigidity, ptosis and upward plantar reflexes were present. After 7 days of empiric treatment without resolution of her symptoms, she had another spinal tap performed...
June 12, 2015: BMJ Case Reports
Nguyen Thi Quynh Nhu, Dorothee Heemskerk, Do Dang Anh Thu, Tran Thi Hong Chau, Nguyen Thi Hoang Mai, Ho Dang Trung Nghia, Pham Phu Loc, Dang Thi Minh Ha, Laura Merson, Tran Thi Van Thinh, Jeremy Day, Nguyen van Vinh Chau, Marcel Wolbers, Jeremy Farrar, Maxine Caws
Tuberculous meningitis (TBM) is the most severe form of tuberculosis. Microbiological confirmation is rare, and treatment is often delayed, increasing mortality and morbidity. The GeneXpert MTB/RIF test was evaluated in a large cohort of patients with suspected tuberculous meningitis. Three hundred seventy-nine patients presenting with suspected tuberculous meningitis to the Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam, between 17 April 2011 and 31 December 2012 were included in the study. Cerebrospinal fluid samples were tested by Ziehl-Neelsen smear, mycobacterial growth indicator tube (MGIT) culture, and Xpert MTB/RIF...
January 2014: Journal of Clinical Microbiology
Gerardo Alvarez-Uria, Jose M Azcona, Manoranjan Midde, Praveen K Naik, Srinivasulu Reddy, Raghuprakash Reddy
HIV-related tuberculosis is difficult to diagnose and is associated with high morbidity and mortality. Recently, the World Health Organization has endorsed the GeneXpert MTB/RIF (Xpert) assay for the diagnosis of pulmonary tuberculosis in HIV-infected patients from developing countries, but information about the use of Xpert for the diagnosis of extrapulmonary tuberculosis is scarce. In this study, we compared the performance of light-emitting diode (LED) auramine fluorescent microscopy and the Xpert assay for the diagnosis of tuberculosis in HIV infected patients in a district hospital of India...
2012: Tuberculosis Research and Treatment
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