Identification of Mycobacterium tuberculosis in the cerebrospinal fluid of patients with meningitis using nested PCR

Nora Rios-Sarabia, Olivia Hernández-González, Jorge González-Y-Merchand, Guadalupe Gordillo, Guillermo Vázquez-Rosales, Leopoldo Muñoz-Pérez, Javier Torres, Carmen Maldonado-Bernal

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Tuberculous meningitis (TBM) is the most severe form of tuberculosis. It is caused by Mycobacterium tuberculosis (M. tuberculosis; MT) and it is very difficult to diagnose. The symptoms are similar to other infectious neurological diseases, such as neurocysticercosis, neuroborreliosis, or herpes viral infection. The aim of this study was to identify tuberculosis (TB) in cases of meningitis with clinical and laboratory evidence suggestive of TBM, and to confirm our findings with molecular tests for TB infection. We recruited patients with neurological symptoms who were examined at the neurology services of Hospitals of Instituto Mexicano del Seguro Social (IMSS) in Mexico City. A total of 144 consecutive patients with suggestive infectious meningitis were initially included; 94 cases of meningitis with clinical and laboratory evidence suggestive of TBM were included, but only 50 of these cases fulfilled the criteria for probable TBM. As the controls, we included 50 cases of meningitis with clinical and laboratory evidence suggestive of non-TBM. Cerebrospinal fluid (CSF) was collected from all 100 patients (cases and controls) and tested for TB by multiplex and nested PCR analyses. Nested PCR detected 0.1 fg of M. tuberculosis DNA. TB infection was confirmed with molecular tests in 49 patients from the 50 cases suggestive of TBM and in 1 of the 50 non-TBM cases. The analysis exhibited a sensitivity of 98.0%, a specificity of 92.0%, a positive predictive value of 88.0% and a negative predictive value of 98.0%. The use CSF for the analyses proved to be effective for the rapid diagnosis of TBM using a developed system of multiplex and nested PCR analyses in patients presenting neurological symptoms.
Original languageAmerican English
Pages (from-to)1289-1295
Number of pages7
JournalInternational Journal of Molecular Medicine
DOIs
StatePublished - 1 Oct 2016

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Meningeal Tuberculosis
Meningitis
Mycobacterium tuberculosis
Cerebrospinal Fluid
Tuberculosis
Polymerase Chain Reaction
Multiplex Polymerase Chain Reaction
Neurocysticercosis
Virus Diseases
Neurology
Mexico
Infection
Communicable Diseases
DNA

Cite this

Rios-Sarabia, Nora ; Hernández-González, Olivia ; González-Y-Merchand, Jorge ; Gordillo, Guadalupe ; Vázquez-Rosales, Guillermo ; Muñoz-Pérez, Leopoldo ; Torres, Javier ; Maldonado-Bernal, Carmen. / Identification of Mycobacterium tuberculosis in the cerebrospinal fluid of patients with meningitis using nested PCR. In: International Journal of Molecular Medicine. 2016 ; pp. 1289-1295.
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title = "Identification of Mycobacterium tuberculosis in the cerebrospinal fluid of patients with meningitis using nested PCR",
abstract = "Tuberculous meningitis (TBM) is the most severe form of tuberculosis. It is caused by Mycobacterium tuberculosis (M. tuberculosis; MT) and it is very difficult to diagnose. The symptoms are similar to other infectious neurological diseases, such as neurocysticercosis, neuroborreliosis, or herpes viral infection. The aim of this study was to identify tuberculosis (TB) in cases of meningitis with clinical and laboratory evidence suggestive of TBM, and to confirm our findings with molecular tests for TB infection. We recruited patients with neurological symptoms who were examined at the neurology services of Hospitals of Instituto Mexicano del Seguro Social (IMSS) in Mexico City. A total of 144 consecutive patients with suggestive infectious meningitis were initially included; 94 cases of meningitis with clinical and laboratory evidence suggestive of TBM were included, but only 50 of these cases fulfilled the criteria for probable TBM. As the controls, we included 50 cases of meningitis with clinical and laboratory evidence suggestive of non-TBM. Cerebrospinal fluid (CSF) was collected from all 100 patients (cases and controls) and tested for TB by multiplex and nested PCR analyses. Nested PCR detected 0.1 fg of M. tuberculosis DNA. TB infection was confirmed with molecular tests in 49 patients from the 50 cases suggestive of TBM and in 1 of the 50 non-TBM cases. The analysis exhibited a sensitivity of 98.0{\%}, a specificity of 92.0{\%}, a positive predictive value of 88.0{\%} and a negative predictive value of 98.0{\%}. The use CSF for the analyses proved to be effective for the rapid diagnosis of TBM using a developed system of multiplex and nested PCR analyses in patients presenting neurological symptoms.",
author = "Nora Rios-Sarabia and Olivia Hern{\'a}ndez-Gonz{\'a}lez and Jorge Gonz{\'a}lez-Y-Merchand and Guadalupe Gordillo and Guillermo V{\'a}zquez-Rosales and Leopoldo Mu{\~n}oz-P{\'e}rez and Javier Torres and Carmen Maldonado-Bernal",
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Rios-Sarabia, N, Hernández-González, O, González-Y-Merchand, J, Gordillo, G, Vázquez-Rosales, G, Muñoz-Pérez, L, Torres, J & Maldonado-Bernal, C 2016, 'Identification of Mycobacterium tuberculosis in the cerebrospinal fluid of patients with meningitis using nested PCR', International Journal of Molecular Medicine, pp. 1289-1295. https://doi.org/10.3892/ijmm.2016.2698

Identification of Mycobacterium tuberculosis in the cerebrospinal fluid of patients with meningitis using nested PCR. / Rios-Sarabia, Nora; Hernández-González, Olivia; González-Y-Merchand, Jorge; Gordillo, Guadalupe; Vázquez-Rosales, Guillermo; Muñoz-Pérez, Leopoldo; Torres, Javier; Maldonado-Bernal, Carmen.

In: International Journal of Molecular Medicine, 01.10.2016, p. 1289-1295.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Identification of Mycobacterium tuberculosis in the cerebrospinal fluid of patients with meningitis using nested PCR

AU - Rios-Sarabia, Nora

AU - Hernández-González, Olivia

AU - González-Y-Merchand, Jorge

AU - Gordillo, Guadalupe

AU - Vázquez-Rosales, Guillermo

AU - Muñoz-Pérez, Leopoldo

AU - Torres, Javier

AU - Maldonado-Bernal, Carmen

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Tuberculous meningitis (TBM) is the most severe form of tuberculosis. It is caused by Mycobacterium tuberculosis (M. tuberculosis; MT) and it is very difficult to diagnose. The symptoms are similar to other infectious neurological diseases, such as neurocysticercosis, neuroborreliosis, or herpes viral infection. The aim of this study was to identify tuberculosis (TB) in cases of meningitis with clinical and laboratory evidence suggestive of TBM, and to confirm our findings with molecular tests for TB infection. We recruited patients with neurological symptoms who were examined at the neurology services of Hospitals of Instituto Mexicano del Seguro Social (IMSS) in Mexico City. A total of 144 consecutive patients with suggestive infectious meningitis were initially included; 94 cases of meningitis with clinical and laboratory evidence suggestive of TBM were included, but only 50 of these cases fulfilled the criteria for probable TBM. As the controls, we included 50 cases of meningitis with clinical and laboratory evidence suggestive of non-TBM. Cerebrospinal fluid (CSF) was collected from all 100 patients (cases and controls) and tested for TB by multiplex and nested PCR analyses. Nested PCR detected 0.1 fg of M. tuberculosis DNA. TB infection was confirmed with molecular tests in 49 patients from the 50 cases suggestive of TBM and in 1 of the 50 non-TBM cases. The analysis exhibited a sensitivity of 98.0%, a specificity of 92.0%, a positive predictive value of 88.0% and a negative predictive value of 98.0%. The use CSF for the analyses proved to be effective for the rapid diagnosis of TBM using a developed system of multiplex and nested PCR analyses in patients presenting neurological symptoms.

AB - Tuberculous meningitis (TBM) is the most severe form of tuberculosis. It is caused by Mycobacterium tuberculosis (M. tuberculosis; MT) and it is very difficult to diagnose. The symptoms are similar to other infectious neurological diseases, such as neurocysticercosis, neuroborreliosis, or herpes viral infection. The aim of this study was to identify tuberculosis (TB) in cases of meningitis with clinical and laboratory evidence suggestive of TBM, and to confirm our findings with molecular tests for TB infection. We recruited patients with neurological symptoms who were examined at the neurology services of Hospitals of Instituto Mexicano del Seguro Social (IMSS) in Mexico City. A total of 144 consecutive patients with suggestive infectious meningitis were initially included; 94 cases of meningitis with clinical and laboratory evidence suggestive of TBM were included, but only 50 of these cases fulfilled the criteria for probable TBM. As the controls, we included 50 cases of meningitis with clinical and laboratory evidence suggestive of non-TBM. Cerebrospinal fluid (CSF) was collected from all 100 patients (cases and controls) and tested for TB by multiplex and nested PCR analyses. Nested PCR detected 0.1 fg of M. tuberculosis DNA. TB infection was confirmed with molecular tests in 49 patients from the 50 cases suggestive of TBM and in 1 of the 50 non-TBM cases. The analysis exhibited a sensitivity of 98.0%, a specificity of 92.0%, a positive predictive value of 88.0% and a negative predictive value of 98.0%. The use CSF for the analyses proved to be effective for the rapid diagnosis of TBM using a developed system of multiplex and nested PCR analyses in patients presenting neurological symptoms.

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DO - 10.3892/ijmm.2016.2698

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JF - International Journal of Molecular Medicine

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