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dc.contributor.authorRoy, RB
dc.contributor.authorThee, S
dc.contributor.authorBlazquez-Gamero, D
dc.contributor.authorFalcon-Neyra, L
dc.contributor.authorNeth, O
dc.contributor.authorNoguera-Julian, A
dc.contributor.authorLillo, C
dc.contributor.authorGalli, L
dc.contributor.authorVenturini, E
dc.contributor.authorBuonsenso, D
dc.contributor.authorGotzinger, F
dc.contributor.authorMartinez-Alier, N
dc.contributor.authorVelizarova, S
dc.contributor.authorBrinkmann, F
dc.contributor.authorWelch, SB
dc.contributor.authorTsolia, M
dc.contributor.authorSantiago-Garcia, B
dc.contributor.authorKruger, R
dc.contributor.authorTebruegge, M
dc.date.accessioned2020-11-26T23:07:02Z
dc.date.available2020-11-26T23:07:02Z
dc.date.issued2020-07-01
dc.identifierpii: 13993003.02004-2019
dc.identifier.citationRoy, R. B., Thee, S., Blazquez-Gamero, D., Falcon-Neyra, L., Neth, O., Noguera-Julian, A., Lillo, C., Galli, L., Venturini, E., Buonsenso, D., Gotzinger, F., Martinez-Alier, N., Velizarova, S., Brinkmann, F., Welch, S. B., Tsolia, M., Santiago-Garcia, B., Kruger, R. & Tebruegge, M. (2020). Performance of immune-based and microbiological tests in children with tuberculosis meningitis in Europe: a multicentre Paediatric Tuberculosis Network European Trials Group (ptbnet) study. EUROPEAN RESPIRATORY JOURNAL, 56 (1), https://doi.org/10.1183/13993003.02004-2019.
dc.identifier.issn0903-1936
dc.identifier.urihttp://hdl.handle.net/11343/252113
dc.description.abstractINTRODUCTION: Tuberculous meningitis (TBM) is often diagnostically challenging. Only limited data exist on the performance of interferon-γ release assays (IGRA) and molecular assays in children with TBM in routine clinical practice, particularly in the European setting. METHODS: Multicentre, retrospective study involving 27 healthcare institutions providing care for children with tuberculosis (TB) in nine European countries. RESULTS: Of 118 children included, 54 (45.8%) had definite, 38 (32.2%) probable and 26 (22.0%) possible TBM; 39 (33.1%) had TBM grade 1, 68 (57.6%) grade 2 and 11 (9.3%) grade 3. Of 108 patients who underwent cranial imaging 90 (83.3%) had at least one abnormal finding consistent with TBM. At the 5-mm cut-off the tuberculin skin test had a sensitivity of 61.9% (95% CI 51.2-71.6%) and at the 10-mm cut-off 50.0% (95% CI 40.0-60.0%). The test sensitivities of QuantiFERON-TB and T-SPOT.TB assays were 71.7% (95% CI 58.4-82.1%) and 82.5% (95% CI 58.2-94.6%), respectively (p=0.53). Indeterminate results were common, occurring in 17.0% of QuantiFERON-TB assays performed. Cerebrospinal fluid (CSF) cultures were positive in 50.0% (95% CI 40.1-59.9%) of cases, and CSF PCR in 34.8% (95% CI 22.9-43.7%). In the subgroup of children who underwent tuberculin skin test, IGRA, CSF culture and CSF PCR simultaneously, 84.4% had at least one positive test result (95% CI 67.8%-93.6%). CONCLUSIONS: Existing immunological and microbiological TB tests have suboptimal sensitivity in children with TBM, with each test producing false-negative results in a substantial proportion of patients. Combining immune-based tests with CSF culture and CSF PCR results in considerably higher positive diagnostic yields, and should therefore be standard clinical practice in high-resource settings.
dc.languageEnglish
dc.publisherEUROPEAN RESPIRATORY SOC JOURNALS LTD
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titlePerformance of immune-based and microbiological tests in children with tuberculosis meningitis in Europe: a multicentre Paediatric Tuberculosis Network European Trials Group (ptbnet) study
dc.typeJournal Article
dc.identifier.doi10.1183/13993003.02004-2019
melbourne.affiliation.departmentPaediatrics (RCH)
melbourne.source.titleEuropean Respiratory Journal
melbourne.source.volume56
melbourne.source.issue1
dc.rights.licensecc-by
melbourne.elementsid1456992
melbourne.contributor.authorTebruegge, Marc
dc.identifier.eissn1399-3003
melbourne.accessrightsOpen Access


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