The microbiological diagnosis of tuberculous meningitis: results of Haydarpasa-1 study
dc.contributor.author | Kursun, E. | |
dc.contributor.pubmedID | 24849547 | en_US |
dc.date.accessioned | 2019-12-18T14:59:56Z | |
dc.date.available | 2019-12-18T14:59:56Z | |
dc.date.issued | 2014 | |
dc.description.abstract | We 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.endpage | O608 | en_US |
dc.identifier.issn | 1198-743X | |
dc.identifier.issue | 10 | en_US |
dc.identifier.scopus | 2-s2.0-84913605718 | en_US |
dc.identifier.startpage | O600 | en_US |
dc.identifier.uri | https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)65393-3/pdf | |
dc.identifier.uri | http://hdl.handle.net/11727/4480 | |
dc.identifier.volume | 20 | en_US |
dc.identifier.wos | 000345825900004 | en_US |
dc.language.iso | eng | en_US |
dc.relation.isversionof | 10.1111/1469-0691.12478 | en_US |
dc.relation.journal | CLINICAL MICROBIOLOGY AND INFECTION | en_US |
dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi | en_US |
dc.rights | info:eu-repo/semantics/openAccess | en_US |
dc.subject | culture | en_US |
dc.subject | diagnosis | en_US |
dc.subject | meningitis | en_US |
dc.subject | PCR | en_US |
dc.subject | tuberculosis | en_US |
dc.title | The microbiological diagnosis of tuberculous meningitis: results of Haydarpasa-1 study | en_US |
dc.type | article | en_US |