Giribhattanavar Prashant, Pirson Chris, Kumar Kavitha, Al-Qahtani Manaf, Shankar Ravi, Chandrashekar Nagarathna, Patil Shripad
Department of Neuromicrobiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore 560029, Karnataka, India.
TB Research Group, Animal and Plant Health Agency, New Haw, Addlestone, Surrey, KT15 3NB, UK.
Access Microbiol. 2020 May 11;2(7):acmi000131. doi: 10.1099/acmi.0.000131. eCollection 2020.
The diagnosis of tuberculous meningitis (TBM) is a major global health concern due to its protean nature. There is a need to identify better biomarkers for the rapid and definitive diagnosis of TBM. Lipids have been poorly explored as diagnostic markers in TBM.
Non-polar lipids (NPL) and mycobacterial sonicate extract (MTSE) antigens were assessed for diagnosis of .
A total of 110 cerebrospinal fluid samples were categorized as confirmed, suspected and non-TBM cases according to clinical presentation and laboratory investigations, which were further analysed by NPL and MTSE ELISA.
The sensitivity and specificity of the NPL ELISA were 39.6 and 96 %, respectively, whereas the MTSE ELISA was 17 % sensitive and 92 % specific. The combination of the NPL and MTSE ELISA test was superior to these tests alone, with sensitivity and specificity of 43 and 88 %, respectively.
This combination may be useful as an adjunct in the laboratory diagnosis of TBM. However, future studies in different settings among different populations, such as those with human immunodeficiency virus co-infection, are desirable to explore the full potential of biomarkers.
结核性脑膜炎(TBM)的诊断因其多变的特性而成为全球主要的健康问题。需要识别更好的生物标志物以实现TBM的快速和明确诊断。脂质作为TBM的诊断标志物尚未得到充分研究。
评估非极性脂质(NPL)和结核分枝杆菌超声提取物(MTSE)抗原用于[此处原文缺失具体诊断对象]的诊断。
根据临床表现和实验室检查,将总共110份脑脊液样本分为确诊、疑似和非TBM病例,进一步通过NPL和MTSE酶联免疫吸附测定(ELISA)进行分析。
NPL ELISA的敏感性和特异性分别为39.6%和96%,而MTSE ELISA的敏感性为17%,特异性为92%。NPL和MTSE ELISA检测的联合应用优于单独使用这些检测,敏感性和特异性分别为43%和88%。
这种联合检测可能有助于TBM的实验室诊断。然而,未来需要在不同人群的不同环境中开展研究,如合并人类免疫缺陷病毒感染的人群,以探索生物标志物的全部潜力。