- Authors:
-
- Erdem, H ;
- Ozturk-Engin, D ;
- Elaldi, N ;
- Gulsun, S ;
- Sengoz, G ;
- Crisan, A ;
- Johansen, Isik Somuncu ;
- Inan, A ;
- Nechifor, M ;
- Al-Mahdawi, A ;
- Civljak, R ;
- Ozguler, M ;
- Savic, B ;
- Ceran, N ;
- Cacopardo, B ;
- Inal, A S ;
- Namiduru, M ;
- Dayan, S ;
- Kayabas, U ;
- Parlak, E ;
- Khalifa, A ;
- Kursun, E ;
- Sipahi, O R ;
- Yemisen, M ;
- Akbulut, A ;
- Bitirgen, M ;
- Dulovic, O ;
- Kandemir, B ;
- Luca, C ;
- Parlak, M ;
- Stahl, J P ;
- Pehlivanoglu, F ;
- Simeon, S ;
- Ulu-Kilic, A ;
- Yasar, K ;
- Yilmaz, G ;
- Yilmaz, E ;
- Beovic, B ;
- Catroux, M ;
- Lakatos, B ;
- Sunbul, M ;
- Oncul, O ;
- Alabay, S ;
- Sahin-Horasan, E ;
- Kose, S ;
- Shehata, G ;
- Andre, K ;
- Alp, A ;
- Cosić, G ;
- Cem Gul, H ;
- Karakas, A ;
- Chadapaud, S ;
- Hansmann, Y ;
- Harxhi, A ;
- Kirova, V ;
- Masse-Chabredier, I ;
- Oncu, S ;
- Sener, A ;
- Tekin, R ;
- Deveci, O ;
- Karabay, O ;
- Agalar, C
- Subtitle:
- results of Haydarpasa-1 study
- DOI:
- 10.1111/1469-0691.12478
- Abstract:
- We aimed to provide data on the diagnosis of tuberculous meningitis (TBM) in this largest case series ever reported. The Haydarpasa-1 study involved patients with microbiologically confirmed TBM in Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria and Turkey between 2000 and 2012. A positive culture, PCR or Ehrlich-Ziehl-Neelsen staining (EZNs) from the cerebrospinal fluid (CSF) was mandatory for inclusion of meningitis patients. A total of 506 TBM patients were included. The sensitivities of the tests were as follows: interferon-γ release assay (Quantiferon TB gold in tube) 90.2%, automated culture systems (ACS) 81.8%, Löwenstein Jensen medium (L-J) 72.7%, adenosine deaminase (ADA) 29.9% and EZNs 27.3%. CSF-ACS was superior to CSF L-J culture and CSF-PCR (p <0.05 for both). Accordingly, CSF L-J culture was superior to CSF-PCR (p <0.05). Combination of L-J and ACS was superior to using these tests alone (p <0.05). There were poor and inverse agreements between EZNs and L-J culture (κ = -0.189); ACS and L-J culture (κ = -0.172) (p <0.05 for both). Fair and inverse agreement was detected for CSF-ADA and CSF-PCR (κ = -0.299, p <0.05). Diagnostic accuracy of TBM was increased when both ACS and L-J cultures were used together. Non-culture tests contributed to TBM diagnosis to a degree. However, due to the delays in the diagnosis with any of the cultures, combined use of non-culture tests appears to contribute early diagnosis. Hence, the diagnostic approach to TBM should be individualized according to the technical capacities of medical institutions particularly in those with poor resources.
- Type:
- Journal article
- Language:
- English
- Published in:
- Clinical Microbiology and Infection, 2014, Vol 20, Issue 10
- Main Research Area:
- Medical science
- Publication Status:
- Published
- Review type:
- Peer Review
- Submission year:
- 2014
- Scientific Level:
- Scientific
- ID:
- 261382849
Checking for on-site access...
