作者
Nathan C Bahr, Edwin Nuwagira, Emily E Evans, Fiona V Cresswell, Philip V Bystrom, Adolf Byamukama, Sarah C Bridge, Ananta S Bangdiwala, David B Meya, Claudia M Denkinger, Conrad Muzoora, David R Boulware, Darlisha A Williams, Kabanda Taseera, Dan Nyehangane, Mugisha Ivan, Patrick Orikiriza, Joshua Rhein, Kathy Huppler Hullsiek, Abdu Musubire, Katelyn Pastick, Pamela Nabeta, James Mwesigye, Radha Rajasingham
发表日期
2018/1/1
期刊
The Lancet infectious diseases
卷号
18
期号
1
页码范围
68-75
出版商
Elsevier
简介
Background
WHO recommends Xpert MTB/RIF as initial diagnostic testing for tuberculous meningitis. However, diagnosis remains difficult, with Xpert sensitivity of about 50–70% and culture sensitivity of about 60%. We evaluated the diagnostic performance of the new Xpert MTB/RIF Ultra (Xpert Ultra) for tuberculous meningitis.
Methods
We prospectively obtained diagnostic cerebrospinal fluid (CSF) specimens during screening for a trial on the treatment of HIV-associated cryptococcal meningitis in Mbarara, Uganda. HIV-infected adults with suspected meningitis (eg, headache, nuchal rigidity, altered mental status) were screened consecutively at Mbarara Regional Referral Hospital. We centrifuged CSF, resuspended the pellet in 2 mL of CSF, and tested 0·5 mL with mycobacteria growth indicator tube culture, 1 mL with Xpert, and cryopreserved 0·5 mL, later tested with Xpert Ultra. We assessed diagnostic …
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NC Bahr, E Nuwagira, EE Evans, FV Cresswell… - The Lancet infectious diseases, 2018