RRML - The usefulness of IS6110 nested polymerase chain reaction in neurotuberculosis diagnosis before and after empirical treatment starting
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Dr. Adrian Man
   
 
Nr. 16(3)/2009
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The usefulness of IS6110 nested polymerase chain reaction in neurotuberculosis diagnosis before and after empirical treatment starting

Simona A. Iacob, Dorina Banica


Abstract:

Objectives. Neurological forms of tuberculosis require prompt diagnosis and urgent therapy. Due to the slow bacteriological diagnosis, most suspected neurotuberculosis patients are urgently treated only on clinical and cerebrospinal fluid (CSF) non-specifically features. The study’s aim was to compare the rapid IS6110 Nested-PCR assay with classical CSF criteria of neurotuberculosis diagnosis regardless of therapy starting. Materials and Methods. 91 CSF samples obtained before and during the first 30 days of antituberculosis treatment from 16 neurotuberculosis patients and 15 controls were evaluated. The CSF samples were analysed using IS6110 Nested-PCR method by comparison with cytological-biochemical and bacteriological CSF criteria of diagnosis. Results. The sensitivity (Sv) of CSF Nested-PCR before antituberculosis therapy was 86.66% with a specificity (Sp) of 87.5% by comparison with 33% Sv and 100% Sp for Lowenstein culture, 6% Sv and 100% Sp for Ziehl Neelsen smear 80% Sv and 87.5% Sp for cytochemical CSF criteria. Nested PCR remained positive after 21 days of therapy at 86.66% patients and up to 30 days at 60% of patients. Conclusions. IS6110 Nested-PCR detection of M. tuberculosis in CSF samples was rapid and accurate in tuberculous meningitis, tuberculoma, cerebral miliaria and tuberculous arahnoiditis, before treatment starting and during the first 21 days of antituberculosis therapy. Importance. The CSF samples were analysed in rare and difficult to diagnose forms of NTB with classic and Nested-PCR methods of diagnosis. IS6110 Nested-PCR method with a Sv of 86.66% improved the diagnosis of high gravity forms of neurotuberculosis even after treatment starting.

Keywords: IS6110 Nested-PCR,neurotuberculosis,treatment

 
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How to cite
Iacob SA, Banica D. The usefulness of IS6110 nested polymerase chain reaction in neurotuberculosis diagnosis before and after empirical treatment starting. Rev Romana Med Lab. 2009;16(3):29-40