Singh Sarman, Sankar Mani Muthu Mani, Singh Jitendra, Rufai Syed Beenish, Kumar Parveen, Kabra Sushil Kumar, Nandan Devaki
Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Microbiology, All India Institute of Medical Sciences, Bhopal, India.
Indian J Pediatr. 2025 May;92(5):535-537. doi: 10.1007/s12098-025-05418-9. Epub 2025 Feb 1.
In tuberculous meningitis (TBM) the paucibacillary nature of the cerebrospinal fluid (CSF) and low sample volume pose a major challenge, especially in young children and low volume samples are often refused by the laboratory. To understand the significance of sample volume, all CSF samples from suspected cases of TBM were accepted. The diagnostic yield of various diagnostic tests was analysed considering various volume ranges. Of the total 571 samples studied, the overall detection rates of Ziehl-Neelsen (ZN) microscopy, culture on Löwenstein-Jensen (LJ) medium, MGIT-960 liquid culture and polymerase chain reaction (PCR) were 0.4%, 8.1%, 18.9% and 13.8%, respectively. Low sample volume did not alter the turnaround time for LJ and MGIT positivity, which was 5.94 ± 0.97 wk for LJ and 20.2 ± 6.4 d for MGIT culture. This study found that if the laboratory is equipped with facilities like MGIT-960 culture and any molecular tests, no amount of CSF should be refused by the laboratory.
在结核性脑膜炎（TBM）中，脑脊液（CSF）菌量少以及样本量少是一项重大挑战，尤其是在幼儿中，而且实验室常常拒收少量样本。为了解样本量的重要性，所有疑似TBM病例的脑脊液样本均被接收。考虑不同的体积范围，分析了各种诊断检测的诊断率。在总共研究的571份样本中，萋-尼（ZN）染色显微镜检查、罗氏（LJ）培养基培养、MGIT-960液体培养和聚合酶链反应（PCR）的总体检出率分别为0.4%、8.1%、18.9%和13.8%。少量样本并未改变LJ和MGIT培养阳性的周转时间，LJ培养阳性的周转时间为5.94±0.97周，MGIT培养阳性的周转时间为20.2±6.4天。本研究发现，如果实验室配备了如MGIT-960培养和任何分子检测等设施，实验室不应拒收任何量的脑脊液样本。
