Diagnosis of tuberculosis meningitis by using Trc4 and Is6110 primers in Bangladesh

Abstract

Meningitis caused by Mycobacterium tuberculosis remains an important cause of morbidity and mortality worldwide, and presents particular challenges in terms of diagnosis and management. The prevalence of TB meningitis remains largely underestimated due to nonspecific clinical manifestation. At early stages diagnosis is largely based on microscopy and culture which are often less sensitive and time consuming. This study was aimed to evaluate the diagnostic potentials of urinary polymerase chain reaction (PCR) by using TRC4 and IS6110 primers. Further the results were also compared by culture on Lowenstein-Jensen (LJ) media and AFB smear by Zeihl-Nelson (ZN) staining. A total of 20 CSF samples were studied from clinically suspected cases of tubercular meningitis. All the samples were processed for conventional ZN staining, TB culture on LJ media and TB-PCR by IS6110 and TRC4 primers by standard protocols. Of the total 20 samples, 12 cases were diagnostically positive TB meningitis samples among which bacteriological test were positive in only 1(8.33%) cases. PCR assay detected MTb in 10(83.33%) patients by TRC4 primers and in 8 (66.67%) patients by IS6110 primers. Since some strains of MTB may lack the IS6110 element in their genome using TRC4 primer instead of IS6110 is superior in diagnosing tubercular meningitis by PCR assay.Citation: Sattar ANI, Setu SK, Firoz TH, et al. Diagnosis of tuberculosis meningitis by using Trc4 and Is611o primers in Bangladesh.

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“…13 This could be also due to cross contamination during tube to tube transfer. 14 The two samples from patients who were clinically positive and responded to antituberculous therapy were negative by PCR using both probe. This false negativity of PCR test can be explained either by sampling errors (non-uniform distribution of microorganisms), low bacterial load, inefficient extraction of DNA, or the presence of PCR inhibitors.…”

Neuroimaging Changes and Treatment Outcome of Tubercular Meningitis- Experiences 22 Cases in a Tertiary Care Center

“…3,4 The prevalence of TB meningitis remains largely underestimated because clinical manifestations are nonspecific in early stages of the disease. 5 The diagnosis poses a special challenge as it is often missed or misdiagnosed due to its variable presentation in children. Prompt diagnosis is critical for initiating appropriate therapy, facilitating measures to prevent dissemination of this highly contagious disease and to combat fatal complication in children.…”