Molecular Methods and Culture in Diagnosis of Tuberculous Meningitis in Children

Authors : Gaurav SHARMA, Bharti MALHOTRA, P J JOHN, Shipra BHARGAVA

Pages : 140-146

Doi:10.5799/jmid.993883

View : 8 | Download : 5

Publication Date : 2021-09-15

Article Type : Research Paper

Abstract :Objectives: This study aimed to detect the incidence of tuberculous meningitis insert ignore into journalissuearticles values(TM); in pediatric patients using GenoType MTBDRplus, GenoType MTBDRsl, and Mycobacteria Growth Indicator Tube insert ignore into journalissuearticles values(MGIT);. Additionally, it aimed to evaluate the utility of GeneXpert MTB/RIF assay in the detection of Mycobacterium tuberculosis in comparison to MGIT culture. Methods: Children under or equal to 15 years of age who were clinically suspected of tuberculous meningitis insert ignore into journalissuearticles values(TBM); were included in the study. Cerebrospinal Fluid insert ignore into journalissuearticles values(CSF); samples were collected and tested for GeneXpert MTB/RIF assay and MGIT culture. Culture-positive samples were further analyzed using Line Probe Assay insert ignore into journalissuearticles values(LPA); to detect drug-resistant mycobacteria. Results: Out of 272 CSF samples, 28 insert ignore into journalissuearticles values(10.3%); samples were positive for MTB, and 5 insert ignore into journalissuearticles values(17.8%); were MDR-TB. GeneXpert MTB/RIF assay detected 23 insert ignore into journalissuearticles values(8.4%); MTB cases of which 3 insert ignore into journalissuearticles values(13%); were rifampicin-resistant. MGIT culture detected the presence of MTB organism in 19 insert ignore into journalissuearticles values(6.9%); cases, of which 6 insert ignore into journalissuearticles values(31.6%); were isoniazid-resistant and 2 insert ignore into journalissuearticles values(10.5%); were rifampicin-resistant by first line LPA. None of the samples had Extensively Drug-Resistant TB insert ignore into journalissuearticles values(XDR-TB);. GeneXpert MTB/RIF assay had 73.6% sensitivity and 96.4% specificity taking MGIT as a gold standard. Conclusion: Total positivity for MTB was seen in 10.3% cases, among which 17.8% were MDR-TB; no XDR-TB was detected in pediatric patients. GeneXpert MTB/RIF assay is a rapid and reliable method for diagnosis of tuberculous meningitis but may miss some cases, so samples should also be cultured in MGIT to enhance yield and for extended sensitivity panel. J Microbiol Infect Dis 2021; 11insert ignore into journalissuearticles values(3);:140-146.
Keywords : Tuberculous meningitis, pediatric, CSF, GeneXpert, MGIT