Improved sensitivity of nucleic acid amplification for rapid diagnosis of tuberculous meningitis

Isik Somuncu Johansen, Bettina Lundgren, Fehmi Tabak, Björn Petrini, Salih Hosoglu, Nese Saltoglu, Vibeke Østergaard Thomsen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Early diagnosis of tuberculous meningitis (TBM) is essential for a positive outcome; but present microbiological diagnostic techniques are insensitive, slow, or laborious. We evaluated the standard BDProbeTec ET strand displacement amplification method (the standard ProbeTec method) for the detection of Mycobacterium tuberculosis complex organisms in parallel with the ProbeTec method with a modified pretreatment procedure with 101 prospectively collected cerebrospinal fluid specimens from 94 patients with suspected TBM. By the modified method, the sample-washing step was omitted. A definitive diagnosis was attained by culture. Thirteen specimens from 12 patients were culture positive for M. tuberculosis complex organisms; three specimens (23%) were microscopy positive for acid-fast bacilli. Among the culture-positive specimens, the standard ProbeTec method was positive for 8 (61.5%) and the modified assay was positive for 10 (76.9%). The overall specificity by both procedures was 98.8% compared to the results of culture. After discrepancy analysis, conducted by reviewing the patients' previous laboratory data, the specificity increased to 100%. If the cutoff value for respiratory specimens was adjusted from the recommended value of 3,400 to 1,000, the sensitivity of the modified procedure increased to 84.7%, with unchanged specificity. Results were obtained in 3 to 4 h. The new pretreatment procedure with the ProbeTec assay described here provides a rapid, simple, and sensitive tool for the diagnosis of TBM.

OriginalsprogEngelsk
TidsskriftJournal of Clinical Microbiology
Vol/bind42
Udgave nummer7
Sider (fra-til)3036-40
Antal sider5
ISSN0095-1137
DOI
StatusUdgivet - jul. 2004

Fingeraftryk

Meningeal Tuberculosis
Nucleic Acids
Mycobacterium tuberculosis
Cerebrospinal Fluid
Microscopy
Acids

Citer dette

Johansen, Isik Somuncu ; Lundgren, Bettina ; Tabak, Fehmi ; Petrini, Björn ; Hosoglu, Salih ; Saltoglu, Nese ; Thomsen, Vibeke Østergaard. / Improved sensitivity of nucleic acid amplification for rapid diagnosis of tuberculous meningitis. I: Journal of Clinical Microbiology. 2004 ; Bind 42, Nr. 7. s. 3036-40.
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abstract = "Early diagnosis of tuberculous meningitis (TBM) is essential for a positive outcome; but present microbiological diagnostic techniques are insensitive, slow, or laborious. We evaluated the standard BDProbeTec ET strand displacement amplification method (the standard ProbeTec method) for the detection of Mycobacterium tuberculosis complex organisms in parallel with the ProbeTec method with a modified pretreatment procedure with 101 prospectively collected cerebrospinal fluid specimens from 94 patients with suspected TBM. By the modified method, the sample-washing step was omitted. A definitive diagnosis was attained by culture. Thirteen specimens from 12 patients were culture positive for M. tuberculosis complex organisms; three specimens (23{\%}) were microscopy positive for acid-fast bacilli. Among the culture-positive specimens, the standard ProbeTec method was positive for 8 (61.5{\%}) and the modified assay was positive for 10 (76.9{\%}). The overall specificity by both procedures was 98.8{\%} compared to the results of culture. After discrepancy analysis, conducted by reviewing the patients' previous laboratory data, the specificity increased to 100{\%}. If the cutoff value for respiratory specimens was adjusted from the recommended value of 3,400 to 1,000, the sensitivity of the modified procedure increased to 84.7{\%}, with unchanged specificity. Results were obtained in 3 to 4 h. The new pretreatment procedure with the ProbeTec assay described here provides a rapid, simple, and sensitive tool for the diagnosis of TBM.",
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Improved sensitivity of nucleic acid amplification for rapid diagnosis of tuberculous meningitis. / Johansen, Isik Somuncu; Lundgren, Bettina; Tabak, Fehmi; Petrini, Björn; Hosoglu, Salih; Saltoglu, Nese; Thomsen, Vibeke Østergaard.

I: Journal of Clinical Microbiology, Bind 42, Nr. 7, 07.2004, s. 3036-40.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Improved sensitivity of nucleic acid amplification for rapid diagnosis of tuberculous meningitis

AU - Johansen, Isik Somuncu

AU - Lundgren, Bettina

AU - Tabak, Fehmi

AU - Petrini, Björn

AU - Hosoglu, Salih

AU - Saltoglu, Nese

AU - Thomsen, Vibeke Østergaard

PY - 2004/7

Y1 - 2004/7

N2 - Early diagnosis of tuberculous meningitis (TBM) is essential for a positive outcome; but present microbiological diagnostic techniques are insensitive, slow, or laborious. We evaluated the standard BDProbeTec ET strand displacement amplification method (the standard ProbeTec method) for the detection of Mycobacterium tuberculosis complex organisms in parallel with the ProbeTec method with a modified pretreatment procedure with 101 prospectively collected cerebrospinal fluid specimens from 94 patients with suspected TBM. By the modified method, the sample-washing step was omitted. A definitive diagnosis was attained by culture. Thirteen specimens from 12 patients were culture positive for M. tuberculosis complex organisms; three specimens (23%) were microscopy positive for acid-fast bacilli. Among the culture-positive specimens, the standard ProbeTec method was positive for 8 (61.5%) and the modified assay was positive for 10 (76.9%). The overall specificity by both procedures was 98.8% compared to the results of culture. After discrepancy analysis, conducted by reviewing the patients' previous laboratory data, the specificity increased to 100%. If the cutoff value for respiratory specimens was adjusted from the recommended value of 3,400 to 1,000, the sensitivity of the modified procedure increased to 84.7%, with unchanged specificity. Results were obtained in 3 to 4 h. The new pretreatment procedure with the ProbeTec assay described here provides a rapid, simple, and sensitive tool for the diagnosis of TBM.

AB - Early diagnosis of tuberculous meningitis (TBM) is essential for a positive outcome; but present microbiological diagnostic techniques are insensitive, slow, or laborious. We evaluated the standard BDProbeTec ET strand displacement amplification method (the standard ProbeTec method) for the detection of Mycobacterium tuberculosis complex organisms in parallel with the ProbeTec method with a modified pretreatment procedure with 101 prospectively collected cerebrospinal fluid specimens from 94 patients with suspected TBM. By the modified method, the sample-washing step was omitted. A definitive diagnosis was attained by culture. Thirteen specimens from 12 patients were culture positive for M. tuberculosis complex organisms; three specimens (23%) were microscopy positive for acid-fast bacilli. Among the culture-positive specimens, the standard ProbeTec method was positive for 8 (61.5%) and the modified assay was positive for 10 (76.9%). The overall specificity by both procedures was 98.8% compared to the results of culture. After discrepancy analysis, conducted by reviewing the patients' previous laboratory data, the specificity increased to 100%. If the cutoff value for respiratory specimens was adjusted from the recommended value of 3,400 to 1,000, the sensitivity of the modified procedure increased to 84.7%, with unchanged specificity. Results were obtained in 3 to 4 h. The new pretreatment procedure with the ProbeTec assay described here provides a rapid, simple, and sensitive tool for the diagnosis of TBM.

KW - Adult

KW - Aged

KW - Female

KW - Humans

KW - Infant

KW - Male

KW - Middle Aged

KW - Nucleic Acid Amplification Techniques

KW - Sensitivity and Specificity

KW - Tuberculosis, Meningeal

KW - Journal Article

U2 - 10.1128/JCM.42.7.3036-3040.2004

DO - 10.1128/JCM.42.7.3036-3040.2004

M3 - Journal article

VL - 42

SP - 3036

EP - 3040

JO - Journal of Clinical Microbiology

JF - Journal of Clinical Microbiology

SN - 0095-1137

IS - 7

ER -