Evidence map›Paper›PMID 38101948›Full record

ArticleThe Journal of antimicrobial chemotherapy2024

Rifampicin and protein concentrations in paired spinal versus ventricular cerebrospinal fluid samples of children with tuberculous meningitis.

Jill Combrinck, Phophi Tshavhungwe, Ursula Rohlwink, Nico Enslin, Nqobile Thango, Jed Lazarus, Katie Kriegler, Sandra Castel, Noha Abdelgawad, Helen Mcilleron and 3 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of antimicrobial chemotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Jill CombrinckDivision of Paediatric Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.ORCID 0000-0003-0936-1761
Phophi TshavhungweDivision of Paediatric Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.
Ursula RohlwinkDivision of Paediatric Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.ORCID 0000-0002-4469-4935
Nico EnslinDivision of Paediatric Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.
Nqobile ThangoDivision of Paediatric Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.
Jed LazarusDivision of Paediatric Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.
Katie KrieglerDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Sandra CastelDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Noha AbdelgawadDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.ORCID 0000-0002-4907-345X
Helen McilleronDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
Paolo DentiDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.ORCID 0000-0001-7494-079X
Lubbe WiesnerDivision of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.ORCID 0000-0002-9070-8699
Anthony FigajiDivision of Paediatric Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.
University of Cape Town · ZA

Funding

National Research Foundation
6 · The paper itself

Abstract

backgroundTuberculous meningitis (TBM) is the most lethal form of TB. To study the disease, drug concentrations in samples obtained from the spinal CSF are usually used to reflect brain concentrations. Emerging data suggest that transport of substances across capillaries in the brain (ventricular CSF) and spinal cord may differ.

methodsWe examined paired, time-linked samples of ventricular CSF (VCSF) and lumbar CSF (LCSF) of 28 patients with TBM and analysed these for rifampicin and total protein concentrations. Clinically indicated samples from procedures to determine the level of CSF block were collected from children being treated for TBM and hydrocephalus. Total protein concentrations were determined using the bicinchoninic acid (BCA) or turbidimetry assay, and rifampicin concentrations were determined using a validated LC coupled with tandem MS method. A paired Wilcoxon signed-rank test was used to determine significance.

resultsTBM was confirmed in 19 cases (68%) using TB culture or GeneXpert Mtb/Rifampicin assay. All other cases were classified as probable. The median total protein concentration in LCSF was 6.0 g/L and in VCSF was 1.3 g/L. The median rifampicin concentration in LCSF was 299 ng/mL and 133 ng/mL in VCSF. The median ratio of LCSF/VSCF for protein was 4.23 and 1.57 for rifampicin.

conclusionsTotal protein and rifampicin concentrations differed significantly between the two compartments, both being higher in LCSF than in VCSF samples (P < 0.0001 for total protein and P = 0.0046 for rifampicin). Further studies are required to explore the causative reasons for the observed differences.

Indexed as

Mycobacterium tuberculosisTuberculosis, MeningealCerebrospinal FluidChildHumansRifampinRifampin

Identifiers

PMID38101948
PMCPMC10832594
OpenAlexW4389805219

What OpenQuestion holds

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Registered trials

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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.