A PROSPECTIVE STUDY ON EVALUATION OF DIAGNOSTIC PERFORMANCE OF GENEXPERT MTB IN CSF FOR EARLY DIAGNOSIS OF TUBERCULAR MENINGITIS IN A TERTIARY CARE HOSPITAL ODISHA.
DOI:
https://doi.org/10.51168/sjhrafrica.v4i12.842Keywords:
GeneXpert, Tuberculous meningitis, Diagnostic accuracyAbstract
Aim
The study aims to establish the diagnostic accuracy of GeneXpert MTB/RIF in CSF for early diagnosis of tubercular meningitis and to compare the efficacy of CSF GeneXpert MTB/RIF with CSF culture for mycobacterium.
Methodology
This was a prospective, cross-sectional study conducted in the Department of Medicine, Neurology, S.C.B Medical College, Cuttack. All patients of age >18 with clinical features suggestive of tubercular meningitis were included in the study. All routine blood tests were performed along with malaria, leptospira, chest radiograph, CT scan or MRI (selected patients) and CSF study to exclude other causes of meningitis. CSF sample subjected to biochemistry, cytology, ZN stain, MGIT culture, and Xpert MTB/RIF. The positive results for each test (ZN stain, MGIT culture, and Xpert MTB/RIF) were compared using Pearson’s chi-squared test. All statistical analyses were done using the SPSS 21.0 version.
Results
Out of 100 suspected TBM patients 40 were finally classified as definite TBM, 6 were probable TBM, 2 were possible TBM, and 52 were not having TBM. Tubercular meningitis occurred more commonly in the population 21-40 years and in males. The overall sensitivity of CSF GeneXpert MTB/RIF, Zn stain, and MGIT culture was 62.5%, 29.16%, and 66.5% respectively, and specificity of 100% for each in diagnosing TBM. Rifampicin resistance was detected only in two cases.
Conclusion
GeneXpert MTB/RIF test can rapidly confirm a diagnosis of TBM with 62.5% sensitivity and 100% specificity, along with rifampicin resistance. It can be a useful diagnostic method in patients of suspected TBM either AFB smear-negative or positive due to its rapidity and simultaneous detection of rifampicin resistance.
Recommendation
Positive GeneXpert results are to be read cautiously and should be well correlated with the clinical and treatment history of the patient.
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Copyright (c) 2023 Aditya Narayan Sahu, Asit Kumar Mallick, Suman Kumar Jagaty, Saswat Subhankar, Debasis Behera, Sankarsan Das
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
