Abstract
Introduction: CNS TB in India is about 1% of all TB cases with high case fatality rates & long term disabilities. Sensitivity of XpertMTB on CSF has been reported to be 55% with a negative predictive value of 80%. The PSQ assay has been reported to yield 98.4% sensitivity in detecting MTB complex in clinical isolates.
Aims and Objectives: To compare yield of CSF-GeneXpertTB & PSQ in diagnosing CNS TB & study drug resistance pattern.
Methods: Prospective study of 10 patients with suspected CNS-TB, 8-Meningitis, 1 lumbar arachnoiditis, 1 tuberculoma were subjected to CSF geneXpert TB, PSQ, liquid cultureMGIT.
CSF AFB smear was negative in all 10. CSF Xpert could detect 50% and CSF-PSQ could identify MTB in all 100%. 5 samples were drug sensitive TB, one FQ resistant, one was pre XDR-TB, one MDR, one drug resistant & 1 INH mono-resistance. Of the 5 MGIT available 1 pre-XDR & FQ resistant co-related with PSQ, 3 were no growth Conclusion: PSQ helps detecting MTB complex directly fromCSF even with negative Xpert. Early diagnosis, detection of resistance aids in administering appropriate treatment early and decrease mortality, long term disability. PSQ shows promising results in diagnosing, early detection of resistance in CNS TB. Though correlation with phenotypic DST recommended & further research warranted.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA4590.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019