ArticleJournal of clinical microbiology2004
Comparison of conventional bacteriology with nucleic acid amplification (amplified mycobacterium direct test) for diagnosis of tuberculous meningitis before and after inception of antituberculosis chemotherapy.
Article in Journal of clinical microbiology, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 103 citations in OpenAlex.
- A Systematic Review and Meta-analysis of the Diagnostic Accuracy of Nucleic Acid Amplification Tests for Tuberculous Meningitis.Journal of clinical microbiology · 2019Pooled it
- Evaluation of processing methods to equitably aliquot sputa for mycobacterial testing.Journal of clinical microbiology · 2012Trial
- Differential diagnosis of tuberculous meningitis from partially-treated pyogenic meningitis by cell ELISA.BMC neurology · 2004Trial
- How Low is Low Volume of Cerebrospinal Fluid from Suspected Cases of Tuberculous Meningitis to Refuse Acceptance in the TB Laboratory?Indian journal of pediatrics · 2025Article
- Tuberculous meningitis diagnosis and treatment: classic approaches and high-throughput pathways.Frontiers in immunology · 2024Review
- Recent advances in microbiological and molecular biological detection techniques of tuberculous meningitis.Frontiers in microbiology · 2023Review
- Treatment Outcomes in Adult Tuberculous Meningitis: A Systematic Review and Meta-analysis.Open forum infectious diseases · 2020Article
- Challenges in the diagnosis of tuberculous meningitis.Journal of clinical tuberculosis and other mycobacterial diseases · 2020Article
- Nontraumatic Myelopathy in Malawi: A Prospective Study in an Area with High HIV Prevalence.The American journal of tropical medicine and hygiene · 2020Article
- Standardized approaches for clinical sampling and endpoint ascertainment in tuberculous meningitis studies.Wellcome open research · 2019Article
- Tuberculous Meningitis-Mimicking Varicella-Zoster Meningitis.Infection & chemotherapy · 2017Article
- HIV-associated opportunistic CNS infections: pathophysiology, diagnosis and treatment.Nature reviews. Neurology · 2016Review
- Cerebrospinal fluid in tuberculous meningitis exhibits only the L-enantiomer of lactic acid.BMC infectious diseases · 2016Article
- Chronic Meningitis: Simplifying a Diagnostic Challenge.Current neurology and neuroscience reports · 2016Article
- Clinical Aspects of Adult Tuberculosis.Cold Spring Harbor perspectives in medicine · 2015Review
- A Five Years Study of Tuberculous Meningitis in Iran.Iranian journal of pathology · 2015Article
- Evaluation and treatment of chronic meningitis.The Neurohospitalist · 2014Article
- The PCR-Based Diagnosis of Central Nervous System Tuberculosis: Up to Date.Tuberculosis research and treatment · 2012Article
- Human Tuberculous Meningitis Caused by Mycobacterium caprae.Case reports in neurology · 2012Article
- The spectrum of central nervous system infections in an adult referral hospital in Hanoi, Vietnam.PloS one · 2012Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
The role of nucleic acid amplification techniques in the rapid diagnosis of tuberculous meningitis remains uncertain. We compared the performance of Ziehl-Neelsen (ZN) staining, the Gen-Probe amplified Mycobacterium tuberculosis direct test (MTD), and culture with 341 cerebrospinal fluid specimens from 152 adults (73 with and 79 without tuberculous meningitis) before and after inception of antituberculosis chemotherapy. The sensitivity, specificity, and positive and negative predictive values of ZN staining before treatment were 34/66 (52%), 79/79 (100%), 34/34 (100%), and 79/111 (71%), compared with 25/66 (38%), 78/79 (99%), 25/26 (96%), and 79/120 (66%) for MTD. The sensitivity of combined ZN staining and MTD (either positive) was 45/66 (68%). The sensitivity of staining and culture fell more rapidly than that of MTD after the start of treatment: after 5 to 15 days of treatment, MTD was more sensitive than ZN staining (12/43 [28%] versus 2/43 [2%]; P = 0.013). Slower bacterial clearance was observed if M. tuberculosis was resistant to isoniazid and/or streptomycin: resistant organisms were more likely to be cultured from cerebrospinal fluid after 2 to 5 days of treatment than fully sensitive organisms (P < 0.001). The sensitivities of ZN staining, MTD, and the two tests combined were improved by repeated sampling to 38/59 (64%), 35/59 (59%), and 49/59 (83%), respectively. In conclusion, ZN staining of the cerebrospinal fluid is at least as good as MTD for the rapid diagnosis of tuberculosis and is much faster and less expensive. However, the combination of these methods on serial samples detects more cases. Alternative tests are still urgently required.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.