Evaluation of the molecular bacterial load assay for detecting viable Mycobacterium tuberculosis in cerebrospinal fluid before and during tuberculous meningitis treatment
| Autor: | Wilber Sabiiti, Hoang Thanh Hai, Guy E. Thwaites, Nguyen Hoan Phu, Nguyen Thuy Thuong Thuong, Do Dang Anh Thu, Stephen H. Gillespie |
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| Přispěvatelé: | University of St Andrews. Infection and Global Health Division, University of St Andrews. School of Medicine, University of St Andrews. Sir James Mackenzie Institute for Early Diagnosis, University of St Andrews. Centre for Biophotonics, University of St Andrews. Global Health Implementation Group, University of St Andrews. Gillespie Group, University of St Andrews. Biomedical Sciences Research Complex |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) medicine.medical_specialty Treatment response Tuberculosis Tuberculosis Meningitis 030106 microbiology Immunology Microbiology Gastroenterology Tuberculosis meningitis Mcobacterium tuberculois Article Tuberculous meningitis Mycobacterium tuberculosis 03 medical and health sciences Cerebrospinal fluid SDG 3 - Good Health and Well-being Limit of Detection RA0421 RNA Ribosomal 16S Internal medicine RA0421 Public health. Hygiene. Preventive Medicine medicine Humans Viable bacterial load 16S rRNA Retrospective Studies GeneXpert MTB/RIF biology business.industry 3rd-DAS Middle Aged biology.organism_classification medicine.disease Bacterial Load 030104 developmental biology Infectious Diseases Tuberculosis Meningeal Female business Bacteria |
| Zdroj: | Tuberculosis (Edinburgh, Scotland) |
| Popis: | Funding: This work was supported by the Wellcome Trust (206724/Z/17/Z to NTTT and 106680/B/14/Z to GT). New tools to monitor treatment response and predict outcome from tuberculous meningitis (TBM) are urgently required. We retrospectively evaluated the 16S rRNA-based molecular bacterial load assay (MBLA) to quantify viable Mycobacterium tuberculosis in serial cerebrospinal fluid (CSF) from adults with TBM. 187 CSF samples were collected before and during the first two months of treatment from 99 adults TBM, comprising 56 definite, 43 probable or possible TBM, and 18 non-TBM and preserved at −80 °C prior to MBLA. We compared MBLA against MGIT culture, GeneXpert MTB/RIF (Xpert) and Ziehl-Neelsen (ZN) smear. Before treatment, MBLA was positive in 34/99 (34.3%), significantly lower than MGIT 47/99 (47.5%), Xpert 51/99 (51.5%) and ZN smear 55/99 (55.5%). After one month of treatment, MBLA and MGIT were positive in 3/38 (7.9%) and 4/38 (10.5%), respectively, whereas Xpert and ZN smear remained positive in 19/38 (50.0%) and 18/38 (47.4%). In summary, MBLA was less likely to detect CSF bacteria before the start of treatment compared with MGIT culture, Xpert and ZN smear. MBLA and MGIT positivity fell during treatment because of detecting only viable bacteria, whereas Xpert and ZN smear remained positive for longer because of detecting both live and dead bacteria. Sample storage and processing may have reduced MBLA-detectable viable bacteria; and sampling earlier in treatment may yield more useful results. Prospective studies with CSF sampling after 1–2 weeks are warranted. Publisher PDF |
| Databáze: | OpenAIRE |
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