สืบค้นงานวิจัย
Evaluation of the GeneXpert MTB/RIF in patients with presumptive tuberculous meningitis
Metcalf T. - ไม่ระบุหน่วยงาน
ชื่อเรื่อง (EN): Evaluation of the GeneXpert MTB/RIF in patients with presumptive tuberculous meningitis
ผู้แต่ง / หัวหน้าโครงการ (EN): Metcalf T.
บทคัดย่อ (EN): Meningitis caused by Mycobacterium tuberculosis is a major cause of morbidity and mortality worldwide. We evaluated the performance of cerebrospinal fluid (CSF) testing with the GeneXpert MTB/RIF assay versus traditional approaches for diagnosing tuberculosis meningitis (TBM). Methods Patients were adults (n = 37) presenting with suspected TBM to the Hospital Nacional Dos de Mayo, Lima, Peru, during 12 months until 1st January 2015. Each participant had a single CSF specimen that was divided into aliquots that were concurrently tested for M. tuberculosis using GeneXpert, Ziehl-Neelsen smear and culture on solid and liquid media. Drug susceptibility testing used Mycobacteria Growth Indicator Tube (MGIT 960) and the proportions method. Results 81% (30/37) of patients received a final clinical diagnosis of TBM, of whom 63% (19/30, 95% confidence intervals, CI: 44–80%) were HIV-positive. 22% (8/37, 95%CI: 9.8–38%), of patients had definite TBM. Because definite TBM was defined by positivity in any laboratory test, all laboratory tests had 100% specificity. Considering the 30 patients who had a clinical diagnosis of TBM: diagnostic sensitivity was 23% (7/30, 95%CI: 9.9–42%) for GeneXpert and was the same for all culture results combined; considerably greater than 7% (2/30, 95%CI: 0.82–22%) for microscopy; whereas all laboratory tests had poor negative predictive values (20–23%). Considering only the 8 patients with definite TBM: diagnostic sensitivity was 88% (7/8, 95%CI: 47–100%) for GeneXpert; 75% (6/8, 95%CI: 35–97%) for MGIT culture or LJ culture; 50% (4/8, 95%CI 16–84) for Ogawa culture and 25% (2/8, 95%CI: 3.2–65%) for microscopy. GeneXpert and microscopy provided same-day results, whereas culture took 20–56 days. GeneXpert provided same-day rifampicin-susceptibility results, whereas culture-based testing took 32–71 days. 38% (3/8, 95%CI: 8.5–76%) of patients with definite TBM with data had evidence of drug-resistant TB, but 73% (22/30) of all clinically diagnosed TBM (definite, probable, and possible TBM) had no drug-susceptibility results available. Conclusions Compared with traditional culture-based methods of CSF testing, GeneXpert had similar yield and faster results for both the detection of M. tuberculosis and drug-susceptibility testing. Including use of the GeneXpert has the capacity to improve the diagnosis of TBM cases. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
บทคัดย่อ: ไม่พบข้อมูลจากหน่วยงานต้นทาง
ภาษา (EN): en
เอกสารแนบ (EN): https://www.scopus.com/inward/record.uri?eid=2-s2.0-85048741268&doi=10.1371%2fjournal.pone.0198695&partnerID=40&md5=1fd299d018b0989b45ebc6ccc4cb4d48
เผยแพร่โดย (EN): มหาวิทยาลัยมหิดล
คำสำคัญ (EN): predictive value
เจ้าของลิขสิทธิ์ (EN): มหาวิทยาลัยมหิดล
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Evaluation of the GeneXpert MTB/RIF in patients with presumptive tuberculous meningitis
Metcalf T.
มหาวิทยาลัยมหิดล
ไม่ระบุวันที่เผยแพร่
Genetic signatures of Mycobacterium tuberculosis Nonthaburi genotype revealed by whole genome analysis of isolates from tuberculous meningitis patients in Thailand เปรียบเทียบการตรวจหาเชื้อวัณโรคแบบรวดเร็ว ด้วยวิธี Xpert MTB/RIF และ TB-LAMP ในผู้ป่วยวัณโรค Comparison of Xpert MTB/RIF and TB-LAMP for rapid detection of Mycobacterium tuberculosis in the Khonkaen H The performance of in-house loop-mediated isothermal amplification for rapid detection of Mycobacterium tuberculosis in sputum sample comparing to Xpert MTB/RIF, microscopy and culture การเปรียบเทียบโมเดลระหว่าง traditional genetic evaluation model และ single-step genomic evaluation models สำหรับลักษณะการสืบพันธุ์ในสุกร Efficacy Evaluation Test 15min Evaluation of Gaseous Stimulation on Panel BO-2 ประสิทธิภาพของวิธี in-house loop-mediated isothermal amplification ในการตรวจหาเชื้อวัณโรคจากตัวอย่างเสมหะ เปรียบเทียบกับวิธี Xpert MTB/RIF Evaluation of HBsAg rapid test kits in Thailand Evaluation of toxic and trace metals in Thai fish by INAA NIRs technique development for kiwifruit flesh color evaluation
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