A Study of Polymerase Chain Reaction in Cerebrospinal Fluid for Diagnosis of Tuberculous Meningitis

Authors

  • Sheena Gupta Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun
  • Alpa Gupta Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun
  • Sanober Wasim Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun
  • Aarti Kotwal Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun
  • Nowneet Kumar Bhat Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun

Keywords:

Polymerase chain reaction, tuberculous meningitis, TBM diagnosis, Mycobacterium tuberculosis

Abstract

Introduction: Tuberculous Meningitis (TBM) is the commonest type of CNS tuberculosis encountered in children of India. This study was undertaken to evaluate the role of TB Polymerase Chain Reaction (PCR) in CSF for rapid diagnosis of TBM.

Methods: All children having CNS illness and undergoing CSF examination were included in the study and were grouped into two. Group I (Study Group) were subjects with the clinical evidence along with one or more of the laboratory or radiological evidence for tuberculous meningitis. Group II (Control Group) comprised of subjects who were diagnosed to have CNS illness other than tuberculous meningitis undergoing CSF examination. CSF samples from all the subjects were subjected to AFB staining, culture and PCR for Mycobacterium tuberculosis.

Results: A total of thirty three subjects were enrolled in the study of which 18 were in Group I and 15 were in Group II. The sensitivity and specificity of TB PCR for diagnosis of TBM was 77.78% & 100%, respectively and positive predictive value was 100% and the negative predictive value was 78.95%.

Conclusion: Analysis of TB PCR in CSF is a sensitive tool with high specificity for making rapid and accurate diagnosis of TBM.

References

Seth V, Kabra SK. Essentials of tuberculosis in children. 2011;4.

Kaneko K, Ondera O, Miyatake T, Tsuji S. Rapid diag-nosis of tuberculous meningitis by polymerase chain re-action. Neurology. 1990; 40: 1617-8.

Murthy J. Tuberculous meningitis: The challenges. Neu-rol India 2010;58:716-22

Daniel TM. New approaches to the rapid diagnosis of tuberculous meningitis. J Infect Dis 1987; 155: 599–603.

Thwaites GE, Caws M, Chau TTH, Dung NT, Campbell JI, Phu NH, Hien TT et al. Comparison of conventional bacteriology with nucleic acid amplification (amplified mycobacterium direct test) for diagnosis of tuberculous meningitis before and after inception of antituberculosis chemotherapy. J Clin Microbiol 2004; 42:996-1002.

Bartlett JMS, Stirling D. A Short History of the Polymer-ase Chain Reaction. PCR Protocols. 2003; 226: 3–6.

Zhuang YH, Lin GL, Zhang XG. Evaluation of detection of M. tuberculosis by DNA amplification. Zhonghua Jie He He Hu Xi Za Zhi. 1993; 16: 26-9.

Kox LF, Kuijper S, Kolk AH. Microwell hybridization assay for detection of PCR products from Mycobacte-rium tuberculosis complex and the recombinant Myco-bacterium smegmatis strain 1008 used as an internal control. J Clin Microbiol. 1996; 34(9): 2117–2120.

Chacko F, Modi M, Lal V, Prabhakar S, Rana SV, Arora SK. Diagnostic efficacy of adenosine deaminase levels in cerebrospinal fluid in patients of tubercular meningitis: A comparison with PCR for Mycobacterium Tuberculosis. Annals of Neurosciences 2010; 17(3):

Bhigjee AI, Padayachee R, Paruk H, Devi K, Pillay H, Marais S, et al. Diagnosis of tuberculous meningitis: clinical and laboratory parameters. International Journal of Infectious Diseases. 2007; 11: 348—54.

Katti MK. Pathogenesis, diagnosis, treatment, and out-come aspects of cerebral tuberculosis. Med Sci Monit. 2004; 10: 215–29.

Thwaites GW, Chau TTH, Stepniewska K. Diagnosis of adult tuberculous meningitis by use of clinical and la-boratory features. The Lancet 2002; 360(9342):. 1287–1292.

Cruciani M, Scarparo C, Malena M, Bosco O, Serpelloni G, Mengoli C. Meta-analysis of BACTEC MGIT 960 and BACTEC 460 TB, with or without solid media, for de-tection of mycbacteria. J Clin Microbiol 2004; 42:2321–25.

Kumar R, Singh SN, Kohli N. A diagnostic rule for tu-berculous meningitis. Arch Dis Child. 1999; 81:221–4.

Mahadevan B, Mahadevan S, Serane VT, Narasimhan R. Tuberculin reactivity in tuberculous meningitis. Indian J Pediatr. 2005 Mar;72(3):213-5.

S. P. Kulkarni, M. A. Jaleel, G. V. Kadival. Evaluation of an in-house-developed PCR for the diagnosis of tuber-culous meningitis in Indian children. J. Medical Microbi-ol. 2005; 54(4): 369–373.

Downloads

Published

2016-03-31

How to Cite

1.
Gupta S, Gupta A, Wasim S, Kotwal A, Bhat NK. A Study of Polymerase Chain Reaction in Cerebrospinal Fluid for Diagnosis of Tuberculous Meningitis. Natl J Community Med [Internet]. 2016 Mar. 31 [cited 2024 Dec. 22];7(03):212-5. Available from: https://njcmindia.com/index.php/file/article/view/896

Issue

Vol. 7 No. 03 (2016)

Section

Original Research Articles

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

The authors retain the copyright of their article, with first publication rights granted to Medsci Publications.