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中枢神经系统人畜共患结核病相关的诊断挑战与前景

Diagnostic Challenges and Prospects Associated With Zoonotic Tuberculosis of Central Nervous System.

作者信息

Bapat Prachi R, Shekhawat Seema D, Husain Aliabbas A, Dodkey Renuka S, Daginawala Hatim F, Singh Lokendra K, Kashyap Rajpal S

机构信息

Research Centre, Central India Institute of Medical Sciences, Nagpur, Maharashtra, India.

出版信息

Basic Clin Neurosci. 2020 Sep-Oct;11(5):619-630. doi: 10.32598/bcn.11.5.10.803.3. Epub 2020 Sep 1.

Abstract

INTRODUCTION

The diagnosis of Tuberculous Meningitis (TBM) has remained a challenge due to its insidious onset and the failure of conventional diagnostic tests. The present study aimed to identify the mycobacterial pathogen in the CSF of patients with TBM and a poor prognosis.

METHODS

We retrospectively recruited 224 TBM and 34 non-TBM patients admitted to the Central India Institute of Medical Sciences, Nagpur, India, in 2014. The CSF samples of these patients were subjected to a duplex PCR assay for the species-specific identification of the causative pathogen.

RESULTS

M. bovis and infection with M.tuberculosis were detected in 7% (18) and 32.9% (85) of the patients, respectively. Moreover, 14% (36) of the study samples were culture positive; however, the mycobacterial pathogens could not be differentiated to the species level.

CONCLUSION

The present study findings emphasized the potentially vital importance of M. bovis identification for appropriate patient management. The obtained data also demonstrated the persistent significance of M. bovis, as a zoonotic pathogen.

摘要

引言

结核性脑膜炎(TBM)的诊断一直是一项挑战,因为其起病隐匿且传统诊断测试效果不佳。本研究旨在鉴定预后不良的TBM患者脑脊液中的分枝杆菌病原体。

方法

我们回顾性招募了2014年入住印度那格浦尔中央印度医学科学研究所的224例TBM患者和34例非TBM患者。对这些患者的脑脊液样本进行双重PCR检测,以对致病病原体进行种属特异性鉴定。

结果

分别在7%(18例)和32.9%(85例)的患者中检测到牛分枝杆菌和结核分枝杆菌感染。此外,14%(36份)的研究样本培养呈阳性;然而,分枝杆菌病原体无法在种属水平上进行区分。

结论

本研究结果强调了鉴定牛分枝杆菌对患者进行适当管理的潜在重要意义。所获得的数据还证明了牛分枝杆菌作为一种人畜共患病原体的持续重要性。

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