The microbiological diagnosis of tuberculous meningitis: results of Haydarpasa-1 study

dc.contributor.authorKursun, E.
dc.contributor.pubmedID24849547en_US
dc.date.accessioned2019-12-18T14:59:56Z
dc.date.available2019-12-18T14:59:56Z
dc.date.issued2014
dc.description.abstractWe aimed to provide data on the diagnosis of tuberculous meningitis (TBM) in this largest case series ever reported. The Haydarpasa-1 study involved patients with microbiologically confirmed TBM in Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria and Turkey between 2000 and 2012. A positive culture, PCR or Ehrlich-Ziehl-Neelsen staining (EZNs) from the cerebrospinal fluid (CSF) was mandatory for inclusion of meningitis patients. A total of 506 TBM patients were included. The sensitivities of the tests were as follows: interferon- release assay (Quantiferon TB gold in tube) 90.2%, automated culture systems (ACS) 81.8%, Lowenstein Jensen medium (L-J) 72.7%, adenosine deaminase (ADA) 29.9% and EZNs 27.3%. CSF-ACS was superior to CSF L-J culture and CSF-PCR (p<0.05 for both). Accordingly, CSF L-J culture was superior to CSF-PCR (p<0.05). Combination of L-J and ACS was superior to using these tests alone (p<0.05). There were poor and inverse agreements between EZNs and L-J culture (=-0.189); ACS and L-J culture (=-0.172) (p<0.05 for both). Fair and inverse agreement was detected for CSF-ADA and CSF-PCR (=-0.299, p<0.05). Diagnostic accuracy of TBM was increased when both ACS and L-J cultures were used together. Non-culture tests contributed to TBM diagnosis to a degree. However, due to the delays in the diagnosis with any of the cultures, combined use of non-culture tests appears to contribute early diagnosis. Hence, the diagnostic approach to TBM should be individualized according to the technical capacities of medical institutions particularly in those with poor resources.en_US
dc.identifier.endpageO608en_US
dc.identifier.issn1198-743X
dc.identifier.issue10en_US
dc.identifier.scopus2-s2.0-84913605718en_US
dc.identifier.startpageO600en_US
dc.identifier.urihttps://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)65393-3/pdf
dc.identifier.urihttp://hdl.handle.net/11727/4480
dc.identifier.volume20en_US
dc.identifier.wos000345825900004en_US
dc.language.isoengen_US
dc.relation.isversionof10.1111/1469-0691.12478en_US
dc.relation.journalCLINICAL MICROBIOLOGY AND INFECTIONen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergien_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectcultureen_US
dc.subjectdiagnosisen_US
dc.subjectmeningitisen_US
dc.subjectPCRen_US
dc.subjecttuberculosisen_US
dc.titleThe microbiological diagnosis of tuberculous meningitis: results of Haydarpasa-1 studyen_US
dc.typearticleen_US

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