Antibody detection tests for early diagnosis in tuberculous meningitis
| Autor: | Xue-Xuan Zhang, Ying Mu Cai, Ying-E Wu, W.G. Peng, M.C. Pang, Q.L. Wu, Teng-Yi Huang, Geng Long Zheng |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Microbiology (medical) medicine.medical_specialty Tuberculosis Antibody detection tests 030106 microbiology MEDLINE Subgroup analysis Cochrane Library Tuberculous meningitis lcsh:Infectious and parasitic diseases Mycobacterium tuberculosis 03 medical and health sciences 0302 clinical medicine Internal medicine Diagnosis Humans Medicine lcsh:RC109-216 030212 general & internal medicine biology Receiver operating characteristic business.industry General Medicine biology.organism_classification medicine.disease Antibodies Bacterial Confidence interval Surgery Early Diagnosis Cerebrospinal fluid Infectious Diseases ROC Curve Tuberculosis Meningeal business |
| Zdroj: | International Journal of Infectious Diseases, Vol 48, Iss C, Pp 64-69 (2016) |
| ISSN: | 1201-9712 |
| DOI: | 10.1016/j.ijid.2016.05.007 |
| Popis: | Summary Background Tuberculous meningitis (TBM) is the most severe form of tuberculosis. Microbiological confirmation is rare and treatment is often delayed. Early diagnosis and immediate initiation of treatment are essential for effective TBM control. A systematic review was performed in this study to assess the diagnostic accuracy of detecting antibodies against Mycobacterium tuberculosis in the cerebrospinal fluid (CSF), according to standard methods. Test performance was summarized using a bivariate random-effects meta-analysis. Methods Studies were identified by a search of the literature, up to July 25, 2015, in the EMBASE and MEDLINE databases via Ovid SP and PubMed. The Cochrane Library was also searched for original, peer-reviewed molecular epidemiology studies that reported the diagnosis of TBM based on antibody detection in the CSF. Results Thirty-six articles (58 studies) were identified. The sensitivity of antibody detection was 0.75 (95% confidence interval (CI) 0.66–0.82), specificity was 0.98 (95% CI 0.96–0.99), and the area under the receiver operating characteristic curve (AUROC) was 0.97 (95% CI 0.95–0.98). By subgroup analysis, the detection of anti-M37Ra was the highest (AUROC 0.99, 95% CI 0.98–1.00), followed by anti-antigen 5 (AUROC 0.99, 95% CI 0.97–0.99) and anti-M37Rv (AUROC 0.97, 95% CI 0.95–0.98). Conclusions For the early diagnosis of TBM based on antibodies in the CSF, the detection of anti-M37Ra, anti-antigen 5, or anti-M37Rv provides the greatest sensitivity and specificity. |
| Databáze: | OpenAIRE |
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