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Journal of Clinical Microbiology, May 1998, p. 1251-1254, Vol. 36, No. 5
Department of Infectious Diseases,
Received 10 November 1997/Returned for modification 24 December
1997/Accepted 10 February 1998
Several nucleic acid-based amplification tests are available for
the detection of Mycobacterium tuberculosis, but few data are available on their use in the diagnosis of tuberculous meningitis (TBM). We performed a prospective study to assess the Roche AMPLICOR Mycobacterium tuberculosis PCR test (TB AMPLICOR) for use
in the diagnosis of TBM and compared it with direct Ziehl-Neelsen
staining of smears, radiometric culture for M. tuberculosis, and clinical and cerebrospinal fluid (CSF)
findings. Eighty-three CSF specimens collected from 69 patients with
suspected meningitis in South Africa were tested by TB AMPLICOR. On the
basis of clinical and laboratory findings, 40 of these patients were
treated for TBM and 29 patients were not treated for TBM. Ten CSF
samples from 10 patients were positive by TB AMPLICOR. Seven of these
10 patients were classified as having definite TBM, 2 were classified
as having probable TBM, and 1 was classified as having possible TBM.
The sensitivity of TB AMPLICOR for detecting cases of definite and probable TBM in patients from whom CSF specimens had been collected less than 10 days into antituberculosis treatment was 60.0%. Specimens from all 29 patients not treated for TBM were negative by the TB
AMPLICOR, giving a 100% specificity. TB AMPLICOR is therefore more
sensitive than the combination of Ziehl-Neelsen staining of smears and
radiometric culture for M. tuberculosis and is a rapid and
highly specific diagnostic test for TBM.
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Use of Roche AMPLICOR Mycobacterium
tuberculosis PCR in Early Diagnosis of Tuberculous
Meningitis

*
Corresponding author. Mailing address: Department of
Infectious Diseases, Monsall Unit, North Manchester General Hospital, Delaunays Rd., North Manchester, M8 5RB, United Kingdom. Phone: 44 (0)
161 445 7315. Fax: 44 (0) 161 720 2562. E-mail:
alec{at}creswell.demon.co.uk.
Present address: Department of Medicine, Milton Keynes Hospital,
Milton Keynes MK6 5LD, United Kingdom.
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