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Journal of Clinical Microbiology, August 1998, p. 2191-2194, Vol. 36, No. 8
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Clinical Evaluation of the Gen-Probe Amplified Direct Test for Detection of Mycobacterium tuberculosis Complex Organisms in Cerebrospinal Fluid

Anne M. Lang,1 Jesus Feris-Iglesias,2 Chabela Pena,2 Jacqueline F. Sanchez,2 Leslie Stockman,1 Paul Rys,1 Glenn D. Roberts,1 Nancy K. Henry,3 David H. Persing,1 and Franklin R. Cockerill III1,4,*

Department of Infectious Diseases, Dr. Robert Reid Cabral Pediatric Hospital, Santo Domingo, Dominican Republic,2 and Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology,1 Division of Infectious Diseases, Department of Pediatrics and Adolescent Medicine,3 and Division of Infectious Diseases, Department of Internal Medicine,4 Mayo Clinic and Foundation, Rochester, Minnesota 55905

Received 13 November 1997/Returned for modification 8 February 1998/Accepted 12 May 1998

Eighty-four cerebrospinal fluid (CSF) samples from different children who presented with signs and symptoms of meningitis were evaluated for the presence of Mycobacterium tuberculosis complex organisms by the Gen-Probe Amplified Mycobacterium tuberculosis Direct Test (MTD; Gen-Probe, San Diego, Calif.). All CSF samples had negative acid-fast smears by the Ziehl-Neelsen staining method. M. tuberculosis was recovered from five samples. M. tuberculosis did not grow from 19 additional samples, but the samples were from patients who fulfilled specific clinical and laboratory criteria for probable tuberculous meningitis (TBM). The remaining samples (n = 60) were from patients with other infections or noninfectious causes of meningitis. The results of the MTD were interpreted as positive or negative on the basis of recommended cutoff values for respiratory specimens. These results were interpreted as true or false positives or true or false negatives on the basis of the results of M. tuberculosis culture or whether the patient fulfilled criteria for probable TBM. The Gen-Probe MTD was 33% sensitive and 100% specific for detecting M. tuberculosis complex organisms in these 84 CSF samples. If the cutoff values for positive results were decreased for the MTD (>= 11,000 versus >= 30,000 relative light units), the sensitivity increased to 83% and the specificity remained 100%. These results for the MTD are encouraging considering that TBM is a highly fatal disease and difficult to diagnose by conventional laboratory techniques.

* Corresponding author. Mailing address: Division of Clinical Microbiology, Mayo Clinic, Hilton 4, 200 First St. S.W., Rochester, MN 55905. Phone: (507) 284-2901. Fax: (507) 284-4272. E-mail: cockerill.franklin{at}mayo.edu.

Journal of Clinical Microbiology, August 1998, p. 2191-2194, Vol. 36, No. 8
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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