Diagnostic characteristics of Xpert MTB/RIF assay for the diagnosis of tuberculous meningitis and rifampicin resistance in Southern Brazil
ABSTRACT Background: The timely diagnosis of tuberculous meningitis (TBM) is challenging. Molecular diagnostic tools are necessary for TBM, particularly in low- and middle-income countries. Objectives: We aimed to calculate the diagnostics characteristics of Xpert MTB/RIF for the detection of Mycoba...
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| Veröffentlicht in: | Arquivos de neuro-psiquiatria 2020-11, Vol.78 (11), p.700-707 |
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| creator | Almeida, Sergio Monteiro de Kussen, Gislene Maria Botão Cogo, Laura Carvalho, José Henrique Nogueira, Keite |
| description | ABSTRACT
Background:
The timely diagnosis of tuberculous meningitis (TBM) is challenging. Molecular diagnostic tools are necessary for TBM, particularly in low- and middle-income countries.
Objectives:
We aimed to calculate the diagnostics characteristics of Xpert MTB/RIF for the detection of
Mycobacterium tuberculosis
in the cerebrospinal fluid (CSF) and the frequency of rifampicin (RIF)-resistance in the CSF samples.
Methods:
A total of 313 consecutive CSF samples were studied and categorized into TBM definite, probable, possible, or not TBM cases based on the clinical, laboratory, and imaging data.
Results:
For the definite TBM cases (n=7), the sensitivity, specificity, efficiency, and positive likelihood ratio were 100, 97, 97, and 38%, respectively. However, for the TBM definite associated with the probable cases (n=24), the sensitivity decreased to 46%. All CSF samples that were Xpert MTB/RIF-positive were RIF susceptible.
Conclusion:
Xpert MTB/RIF showed high discriminating value among the microbiology-proven TBM cases, although the values for the probable and possible TBM cases were reduced. Xpert MTB/RIF contributes significantly to the diagnosis of TBM, mainly when coupled with the conventional microbiological tests and clinical algorithms. |
| doi_str_mv | 10.1590/0004-282X20200067 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_scielo_journals_S0004_282X2020001100700</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><scielo_id>S0004_282X2020001100700</scielo_id><doaj_id>oai_doaj_org_article_318d4fa30c094f29b3eee8f3c708a85f</doaj_id><sourcerecordid>2470899418</sourcerecordid><originalsourceid>FETCH-LOGICAL-c490t-ee52883bdc8eb78ed44cb6edf088ecb472218ba9f47aa37b4a203329713a34f93</originalsourceid><addsrcrecordid>eNpdUk1vEzEUXCEQDYUfwAX5yCWtvxLbR9pSiFSERIvUm_XW-5w42l0He1ei_AR-NU63SSV8sZ_fzPhpxlX1ntEztjD0nFIq51zze055OS_Vi2rGlkrPJefqZTU79k-qNzlvKeXSGPW6OhFlMbmUs-rvVYB1H_MQHHEbSOAGTGFfZhI9ud9hGsi3u4vzH6trAjnDA_ExkWGDpJmY4RE4jDUmN7ZxzKTDPvTrMJQO9A1JwUO3Cy70JGGBD9A7JKW6jWPRST25SPAntG-rVx7ajO-e9tPq5_Xnu8uv85vvX1aXn27mTho6zBEXXGtRN05jrTQ2Urp6iY2nWqOrpeKc6RqMlwpAqFoCp0Jwo5gAIb0Rp9Vq0m0ibO0uhQ7Sg40Q7ONFTGsLqRjQohVMN9KDoI4a6bmpBSJqL5yiGvTCF62zSSu7gG202zimvgxvb_fe2-dsGKNUUVoIHyfCLsVfI-bBdiE7bFvosXhnuSzSxkimC5RNUJdizgn9cVZG7T5_e3jj9yH_wvnwJD_WHTZHxiHwAqATYNgE7PB54P81j39K_ANILrji</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2470899418</pqid></control><display><type>article</type><title>Diagnostic characteristics of Xpert MTB/RIF assay for the diagnosis of tuberculous meningitis and rifampicin resistance in Southern Brazil</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Thieme Connect Journals Open Access</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Almeida, Sergio Monteiro de ; Kussen, Gislene Maria Botão ; Cogo, Laura ; Carvalho, José Henrique ; Nogueira, Keite</creator><creatorcontrib>Almeida, Sergio Monteiro de ; Kussen, Gislene Maria Botão ; Cogo, Laura ; Carvalho, José Henrique ; Nogueira, Keite</creatorcontrib><description>ABSTRACT
Background:
The timely diagnosis of tuberculous meningitis (TBM) is challenging. Molecular diagnostic tools are necessary for TBM, particularly in low- and middle-income countries.
Objectives:
We aimed to calculate the diagnostics characteristics of Xpert MTB/RIF for the detection of
Mycobacterium tuberculosis
in the cerebrospinal fluid (CSF) and the frequency of rifampicin (RIF)-resistance in the CSF samples.
Methods:
A total of 313 consecutive CSF samples were studied and categorized into TBM definite, probable, possible, or not TBM cases based on the clinical, laboratory, and imaging data.
Results:
For the definite TBM cases (n=7), the sensitivity, specificity, efficiency, and positive likelihood ratio were 100, 97, 97, and 38%, respectively. However, for the TBM definite associated with the probable cases (n=24), the sensitivity decreased to 46%. All CSF samples that were Xpert MTB/RIF-positive were RIF susceptible.
Conclusion:
Xpert MTB/RIF showed high discriminating value among the microbiology-proven TBM cases, although the values for the probable and possible TBM cases were reduced. Xpert MTB/RIF contributes significantly to the diagnosis of TBM, mainly when coupled with the conventional microbiological tests and clinical algorithms.</description><identifier>ISSN: 0004-282X</identifier><identifier>ISSN: 1678-4227</identifier><identifier>EISSN: 1678-4227</identifier><identifier>DOI: 10.1590/0004-282X20200067</identifier><identifier>PMID: 33331464</identifier><language>eng</language><publisher>Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil: Thieme Revinter Publicações Ltda</publisher><subject>Brazil ; Central Nervous System ; Diagnosis ; Humans ; Mycobacterium tuberculosis - genetics ; NEUROSCIENCES ; Polymerase Chain Reaction ; PSYCHIATRY ; Rifampin - pharmacology ; Sensitivity and Specificity ; Tuberculosis, Meningeal ; Tuberculosis, Meningeal - diagnosis ; Tuberculosis, Meningeal - drug therapy</subject><ispartof>Arquivos de neuro-psiquiatria, 2020-11, Vol.78 (11), p.700-707</ispartof><rights>Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon.</rights><rights>This work is licensed under a Creative Commons Attribution 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490t-ee52883bdc8eb78ed44cb6edf088ecb472218ba9f47aa37b4a203329713a34f93</citedby><cites>FETCH-LOGICAL-c490t-ee52883bdc8eb78ed44cb6edf088ecb472218ba9f47aa37b4a203329713a34f93</cites><orcidid>0000-0003-4549-4094 ; 0000-0001-5655-9645 ; 0000-0003-0469-8883 ; 0000-0002-6944-9215 ; 0000-0001-5690-105X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.thieme-connect.de/products/ejournals/pdf/10.1590/0004-282X20200067.pdf$$EPDF$$P50$$Gthieme$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.thieme-connect.de/products/ejournals/html/10.1590/0004-282X20200067$$EHTML$$P50$$Gthieme$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,864,885,20891,27924,27925,54587,54615</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33331464$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Almeida, Sergio Monteiro de</creatorcontrib><creatorcontrib>Kussen, Gislene Maria Botão</creatorcontrib><creatorcontrib>Cogo, Laura</creatorcontrib><creatorcontrib>Carvalho, José Henrique</creatorcontrib><creatorcontrib>Nogueira, Keite</creatorcontrib><title>Diagnostic characteristics of Xpert MTB/RIF assay for the diagnosis of tuberculous meningitis and rifampicin resistance in Southern Brazil</title><title>Arquivos de neuro-psiquiatria</title><addtitle>Arq Neuropsiquiatr</addtitle><description>ABSTRACT
Background:
The timely diagnosis of tuberculous meningitis (TBM) is challenging. Molecular diagnostic tools are necessary for TBM, particularly in low- and middle-income countries.
Objectives:
We aimed to calculate the diagnostics characteristics of Xpert MTB/RIF for the detection of
Mycobacterium tuberculosis
in the cerebrospinal fluid (CSF) and the frequency of rifampicin (RIF)-resistance in the CSF samples.
Methods:
A total of 313 consecutive CSF samples were studied and categorized into TBM definite, probable, possible, or not TBM cases based on the clinical, laboratory, and imaging data.
Results:
For the definite TBM cases (n=7), the sensitivity, specificity, efficiency, and positive likelihood ratio were 100, 97, 97, and 38%, respectively. However, for the TBM definite associated with the probable cases (n=24), the sensitivity decreased to 46%. All CSF samples that were Xpert MTB/RIF-positive were RIF susceptible.
Conclusion:
Xpert MTB/RIF showed high discriminating value among the microbiology-proven TBM cases, although the values for the probable and possible TBM cases were reduced. Xpert MTB/RIF contributes significantly to the diagnosis of TBM, mainly when coupled with the conventional microbiological tests and clinical algorithms.</description><subject>Brazil</subject><subject>Central Nervous System</subject><subject>Diagnosis</subject><subject>Humans</subject><subject>Mycobacterium tuberculosis - genetics</subject><subject>NEUROSCIENCES</subject><subject>Polymerase Chain Reaction</subject><subject>PSYCHIATRY</subject><subject>Rifampin - pharmacology</subject><subject>Sensitivity and Specificity</subject><subject>Tuberculosis, Meningeal</subject><subject>Tuberculosis, Meningeal - diagnosis</subject><subject>Tuberculosis, Meningeal - drug therapy</subject><issn>0004-282X</issn><issn>1678-4227</issn><issn>1678-4227</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>0U6</sourceid><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNpdUk1vEzEUXCEQDYUfwAX5yCWtvxLbR9pSiFSERIvUm_XW-5w42l0He1ei_AR-NU63SSV8sZ_fzPhpxlX1ntEztjD0nFIq51zze055OS_Vi2rGlkrPJefqZTU79k-qNzlvKeXSGPW6OhFlMbmUs-rvVYB1H_MQHHEbSOAGTGFfZhI9ud9hGsi3u4vzH6trAjnDA_ExkWGDpJmY4RE4jDUmN7ZxzKTDPvTrMJQO9A1JwUO3Cy70JGGBD9A7JKW6jWPRST25SPAntG-rVx7ajO-e9tPq5_Xnu8uv85vvX1aXn27mTho6zBEXXGtRN05jrTQ2Urp6iY2nWqOrpeKc6RqMlwpAqFoCp0Jwo5gAIb0Rp9Vq0m0ibO0uhQ7Sg40Q7ONFTGsLqRjQohVMN9KDoI4a6bmpBSJqL5yiGvTCF62zSSu7gG202zimvgxvb_fe2-dsGKNUUVoIHyfCLsVfI-bBdiE7bFvosXhnuSzSxkimC5RNUJdizgn9cVZG7T5_e3jj9yH_wvnwJD_WHTZHxiHwAqATYNgE7PB54P81j39K_ANILrji</recordid><startdate>202011</startdate><enddate>202011</enddate><creator>Almeida, Sergio Monteiro de</creator><creator>Kussen, Gislene Maria Botão</creator><creator>Cogo, Laura</creator><creator>Carvalho, José Henrique</creator><creator>Nogueira, Keite</creator><general>Thieme Revinter Publicações Ltda</general><general>Academia Brasileira de Neurologia - ABNEURO</general><general>Academia Brasileira de Neurologia (ABNEURO)</general><scope>0U6</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>GPN</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-4549-4094</orcidid><orcidid>https://orcid.org/0000-0001-5655-9645</orcidid><orcidid>https://orcid.org/0000-0003-0469-8883</orcidid><orcidid>https://orcid.org/0000-0002-6944-9215</orcidid><orcidid>https://orcid.org/0000-0001-5690-105X</orcidid></search><sort><creationdate>202011</creationdate><title>Diagnostic characteristics of Xpert MTB/RIF assay for the diagnosis of tuberculous meningitis and rifampicin resistance in Southern Brazil</title><author>Almeida, Sergio Monteiro de ; Kussen, Gislene Maria Botão ; Cogo, Laura ; Carvalho, José Henrique ; Nogueira, Keite</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c490t-ee52883bdc8eb78ed44cb6edf088ecb472218ba9f47aa37b4a203329713a34f93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Brazil</topic><topic>Central Nervous System</topic><topic>Diagnosis</topic><topic>Humans</topic><topic>Mycobacterium tuberculosis - genetics</topic><topic>NEUROSCIENCES</topic><topic>Polymerase Chain Reaction</topic><topic>PSYCHIATRY</topic><topic>Rifampin - pharmacology</topic><topic>Sensitivity and Specificity</topic><topic>Tuberculosis, Meningeal</topic><topic>Tuberculosis, Meningeal - diagnosis</topic><topic>Tuberculosis, Meningeal - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Almeida, Sergio Monteiro de</creatorcontrib><creatorcontrib>Kussen, Gislene Maria Botão</creatorcontrib><creatorcontrib>Cogo, Laura</creatorcontrib><creatorcontrib>Carvalho, José Henrique</creatorcontrib><creatorcontrib>Nogueira, Keite</creatorcontrib><collection>Thieme Connect Journals Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SciELO</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Arquivos de neuro-psiquiatria</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Almeida, Sergio Monteiro de</au><au>Kussen, Gislene Maria Botão</au><au>Cogo, Laura</au><au>Carvalho, José Henrique</au><au>Nogueira, Keite</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic characteristics of Xpert MTB/RIF assay for the diagnosis of tuberculous meningitis and rifampicin resistance in Southern Brazil</atitle><jtitle>Arquivos de neuro-psiquiatria</jtitle><addtitle>Arq Neuropsiquiatr</addtitle><date>2020-11</date><risdate>2020</risdate><volume>78</volume><issue>11</issue><spage>700</spage><epage>707</epage><pages>700-707</pages><issn>0004-282X</issn><issn>1678-4227</issn><eissn>1678-4227</eissn><abstract>ABSTRACT
Background:
The timely diagnosis of tuberculous meningitis (TBM) is challenging. Molecular diagnostic tools are necessary for TBM, particularly in low- and middle-income countries.
Objectives:
We aimed to calculate the diagnostics characteristics of Xpert MTB/RIF for the detection of
Mycobacterium tuberculosis
in the cerebrospinal fluid (CSF) and the frequency of rifampicin (RIF)-resistance in the CSF samples.
Methods:
A total of 313 consecutive CSF samples were studied and categorized into TBM definite, probable, possible, or not TBM cases based on the clinical, laboratory, and imaging data.
Results:
For the definite TBM cases (n=7), the sensitivity, specificity, efficiency, and positive likelihood ratio were 100, 97, 97, and 38%, respectively. However, for the TBM definite associated with the probable cases (n=24), the sensitivity decreased to 46%. All CSF samples that were Xpert MTB/RIF-positive were RIF susceptible.
Conclusion:
Xpert MTB/RIF showed high discriminating value among the microbiology-proven TBM cases, although the values for the probable and possible TBM cases were reduced. Xpert MTB/RIF contributes significantly to the diagnosis of TBM, mainly when coupled with the conventional microbiological tests and clinical algorithms.</abstract><cop>Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil</cop><pub>Thieme Revinter Publicações Ltda</pub><pmid>33331464</pmid><doi>10.1590/0004-282X20200067</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4549-4094</orcidid><orcidid>https://orcid.org/0000-0001-5655-9645</orcidid><orcidid>https://orcid.org/0000-0003-0469-8883</orcidid><orcidid>https://orcid.org/0000-0002-6944-9215</orcidid><orcidid>https://orcid.org/0000-0001-5690-105X</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Thieme Connect Journals Open Access; EZB-FREE-00999 freely available EZB journals |
| subjects | Brazil Central Nervous System Diagnosis Humans Mycobacterium tuberculosis - genetics NEUROSCIENCES Polymerase Chain Reaction PSYCHIATRY Rifampin - pharmacology Sensitivity and Specificity Tuberculosis, Meningeal Tuberculosis, Meningeal - diagnosis Tuberculosis, Meningeal - drug therapy |
| title | Diagnostic characteristics of Xpert MTB/RIF assay for the diagnosis of tuberculous meningitis and rifampicin resistance in Southern Brazil |
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