Diagnostic value of culture of Mycobacterium tuberculosis combined with molecular diagnostic technique in patients with tuberculous meningitis
Objective To explore the value of Mycobacterium tuberculosis culture combined with molecular diagnostic technique in patients with tuberculous meningitis(TBM).Methods From September 2021 to February 2023,102 patients who were suspected of TBM and met the inclusion criteria from the Second Affiliated Hospital of Xinjiang Medical University were selected.According to the clinical diagnostic criteria,the patients were divided into TBM group(n=72,including confirmed TBM 21 cases,probable TBM 22 cases,probable TBM 29 cases)and non-TBM group(n=30).And the cerebrospinal fluid was obtained by lumbar puncture;Mycobacterium tuberculosis was detected by culturing,GeneXpert MTB/RIF(Xpert)and GeneXpert MTB/RIF Ultra(Xpert Ultra).The diagnostic efficacy of independent and combined detection methods for TBM was compared.Results Among them,there was significant difference in sensitivity(x2=8.298,P=0.006)and consistency rate(x2=5.829,P=0.023)between Mycobacterium tuberculosis culture and Xpert Ultra detection,but there was no significant difference in sensitivity,negative predictive value and consistency among other detection methods(P＞0.05).There were significant differences in sensitivity,negative predictive value and consistent rate between Mycobacterium tuberculosis culture combined with Xpert and the three combined detection methods(x2=10.350,4.105,9.094;P=0.002,0.049,0.004),but there was no significant difference in sensitivity,negative predictive value and consistent rate among other combined detection methods(P＞0.05).Conclusions The sensitivity and consistency of Xpert Ultra in independent diagnosis of TBM were higher than those of culture test and Xpert test of Mycobacterium tuberculosis,while the combined application of culture of Mycobacterium tuberculosis and any molecular diagnostic technique could improve the diagnostic sensitivity of TBM.Therefore,combined detection should be recommended for early diagnosis of TBM when clinical conditions permit.
Culture of Mycobacterium tuberculosisMolecular diagnosisTuberculous meningitis
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