| Title: |
Predictors of cerebrospinal fluid GeneXpert MTB/RIF positivity in patients with tuberculous meningitis: A prospective cohort study |
| Authors: |
Priyanka Gupta, Neeraj Kumar, Ravindra Kumar Garg, Hardeep Singh Malhotra, Imran Rizvi, Rajesh Verma, Praveen Kumar Sharma, Ravi Uniyal, Shweta Pandey, Amita Jain, Parul Jain |
| Source: |
Asian Pacific Journal of Tropical Medicine, Vol 17, Iss 10, Pp 465-472 (2024) |
| Publisher Information: |
Wolters Kluwer Medknow Publications, 2024. |
| Publication Year: |
2024 |
| Collection: |
LCC:Arctic medicine. Tropical medicine |
| Subject Terms: |
tuberculous meningitis, mycobacterium tuberculosis, cerebrospinal fluid, ziehl-neelsen staining, genexpert, Arctic medicine. Tropical medicine, RC955-962 |
| More Details: |
Objective: To identify the clinical, laboratory, and radiological markers that could predict a positive GeneXpert result in patients suspected of tuberculous meningitis. Methods: In this prospective, observational study, patients with tuberculous meningitis were systematically evaluated. Various clinical, laboratory [including cerebrospinal fluid (CSF) microscopy, culture, and GeneXpert], and neuroimaging factors were examined. All participants were administered anti-tuberculous treatment and corticosteroids. A six-month follow-up was done to evaluate the outcome. Results: Of the 116 patients studied, 54 (46.6%) tested positive for GeneXpert, while 62 (53.4%) were negative. Third cranial nerve involvement (OR 3.71, 95% CI 1.052-13.09, P=0.04) and the presence of basal exudates on neuroimaging (OR 5.22, 95% CI 2.03-13.42, P=0.001) emerged as independent predictive factors for a positive GeneXpert result. A positive CSF GeneXpert result (P=0.002) and drug resistance (P=0.004) were significantly linked to adverse outcomes. Additionally, a high score on the Medical Research Council stage III (OR 5.64, 95% CI 1.18-26.87, P=0.03) and elevated CSF cell counts (OR 1.002, 95% CI 1.00-1.001, P=0.03) were identified as independent predictors of poor prognosis. Conclusions: Third cranial nerve involvement and the presence of basal exudates were significant indicators of a positive GeneXpert result. MRC stage III disability and elevated CSF cell counts predicted poor outcomes. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2352-4146 |
| Relation: |
https://journals.lww.com/10.4103/apjtm.apjtm_60_24; https://doaj.org/toc/2352-4146 |
| DOI: |
10.4103/apjtm.apjtm_60_24 |
| Access URL: |
https://doaj.org/article/ec831fe9f02341bb9659762709dea6c9 |
| Accession Number: |
edsdoj.831fe9f02341bb9659762709dea6c9 |
| Database: |
Directory of Open Access Journals |
