Evaluation of IS6110 PCR in CSF for the rapid diagnosis of tuberculous meningitis

Abstract

Background: Tuberculous meningitis (TBM) is a major, global public health problem and its diagnosis remains problematic even after years of experience. Early diagnosis and treatment are of paramount importance as a delay in diagnosis can lead to irreversible central nervous system damage and mortality. Aims: To evaluate the role of cerebrospinal fluid (CSF) IS6110-based tuberculosis (TB) polymerase chain reaction analysis (PCR) as an efficient diagnostic tool for the diagnosis of TBM. Materials and Methods: This is a cross-sectional study carried out with patients clinically suspected to have TBM. A total of 102 cases were enrolled, out of which 15 patients were excluded from the study because of alternative diagnoses. An in-house IS6110-PCR method using a specific pair of primers designed to amplify the insertion sequence, IS6110 in the Mycobacterium tuberculosis genome was used to analyze CSF. Results: Our study showed PCR positivity in 51.7% cases. PCR gave a sensitivity of 100% and specificity of 68.9% against the cases of TBM confirmed by culture. Conclusion: IS6110 TB-PCR is a novel diagnostic tool that can diagnose a greater number of individuals with clinically suspected TBM with its rapidity, accuracy, and reliability, and its positivity even after 4 weeks of starting treatment makes it the diagnostic tool of choice.