Diagnosis of tuberculosis meningitis by using Trc4 and Is6110 primers in Bangladesh

Abstract

Meningitis caused by Mycobacterium tuberculosis remains an important cause of morbidity and mortality worldwide and presents particular challenges in terms of diagnosis and management The prevalence of TB meningitis remains largely underestimated due to nonspecific clinical manifestation At early stages diagnosis is largely based on microscopy and culture which are often less sensitive and time consuming This study was aimed to evaluate the diagnostic potentials of urinary polymerase chain reaction PCR by using TRC and IS primers Further the results were also compared by culture on Lowenstein Jensen LJ media and AFB smear by Zeihl Nelson ZN staining A total of CSF samples were studied from clinically suspected cases of tubercular meningitis All the samples were processed for conventional ZN staining TB culture on LJ media and TB PCR by IS and TRC primers by standard protocols Of the total samples cases were diagnostically positive TB meningitis samples among which bacteriological test were positive in only cases PCR assay detected MTb in patients by TRC primers and in patients by IS primers Since some strains of MTB may lack the IS element in their genome using TRC primer instead of IS is superior in diagnosing tubercular meningitis by PCR assay