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首页> 外文期刊>Journal of Clinical Microbiology >Improved Sensitivity of Nucleic Acid Amplification for Rapid Diagnosis of Tuberculous Meningitis
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Improved Sensitivity of Nucleic Acid Amplification for Rapid Diagnosis of Tuberculous Meningitis

机译：核酸扩增灵敏度的提高，可快速诊断结核性脑膜炎

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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.
机译：结核性脑膜炎（TBM）的早期诊断对于阳性结果至关重要。但是目前的微生物诊断技术不灵敏，缓慢或费力。我们评估了标准BDProbeTec ET链置换扩增方法（标准ProbeTec方法）与ProbeTec方法的并行性，同时采用改良的预处理程序对101例预期收集的脑脊髓液标本进行检测，以检测结核分枝杆菌复杂生物94例疑似TBM患者。通过改进的方法，省去了样品洗涤步骤。通过文化获得了明确的诊断。来自12位患者的13个标本的 M培养呈阳性。结核病复杂生物;三个标本（23％）在显微镜下呈抗酸杆菌阳性。在培养阳性样本中，标准ProbeTec方法为8阳性（61.5％），改良分析为10阳性（76.9％）。与培养结果相比，两种方法的总体特异性为98.8％。通过检查患者以前的实验室数据进行差异分析后，特异性提高到100％。如果将呼吸道标本的临界值从建议的3,400调整为1,000，修改后的程序的灵敏度将提高至84.7％，而特异性不变。在3至4小时内获得结果。本文所述的使用ProbeTec测定的新预处理程序为诊断TBM提供了一种快速，简单且灵敏的工具。

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