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http://hdl.handle.net/2445/173184
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DC Field | Value | Language |
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dc.contributor.author | Basu Roy, Robindra | - |
dc.contributor.author | Thee, Stephanie | - |
dc.contributor.author | Blázquez Gamero, Daniel | - |
dc.contributor.author | Falcón Neyra, Lola | - |
dc.contributor.author | Neth, Olaf | - |
dc.contributor.author | Noguera Julian, Antoni | - |
dc.contributor.author | Lillo, Cristina | - |
dc.contributor.author | Galli, Luisa | - |
dc.contributor.author | Venturini, Elisabetta | - |
dc.contributor.author | Buonsenso, Danilo | - |
dc.contributor.author | Götzinger, Florian | - |
dc.contributor.author | Martinez Alier, Nuria | - |
dc.contributor.author | Velizarova, Svetlana | - |
dc.contributor.author | Brinkmann, Folke | - |
dc.contributor.author | Welch ,Steven B. | - |
dc.contributor.author | Tsolia, Maria | - |
dc.contributor.author | Santiago Garcia, Begoña | - |
dc.contributor.author | Krüger, Renate | - |
dc.contributor.author | Tebruegge, Marc | - |
dc.contributor.author | ptbnet TB Meningitis Study Group | - |
dc.date.accessioned | 2021-01-19T12:08:12Z | - |
dc.date.available | 2021-01-19T12:08:12Z | - |
dc.date.issued | 2020-04-16 | - |
dc.identifier.issn | 0903-1936 | - |
dc.identifier.uri | http://hdl.handle.net/2445/173184 | - |
dc.description.abstract | Introduction: 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.format.extent | 11 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | European Respiratory Society | - |
dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.1183/13993003.02004-2019 | - |
dc.relation.ispartof | European Respiratory Journal, 2020, vol. 56, p. 1902004 | - |
dc.relation.uri | https://doi.org/10.1183/13993003.02004-2019 | - |
dc.rights | cc by (c) European Respiratory Society, 2020 | - |
dc.rights.uri | http://creativecommons.org/licenses/by/3.0/es/ | - |
dc.source | Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques) | - |
dc.subject.classification | Meningitis | - |
dc.subject.classification | Tuberculosi | - |
dc.subject.classification | Infants | - |
dc.subject.other | Meningitis | - |
dc.subject.other | Tuberculosis | - |
dc.subject.other | Children | - |
dc.title | Performance of immune-based and microbiological tests in children with TB meningitis in Europe - a multi-center Paediatric Tuberculosis Network European Trials Group (ptbnet) study | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.identifier.idgrec | 699008 | - |
dc.date.updated | 2021-01-19T12:08:13Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 32299859 | - |
Appears in Collections: | Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques) |
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699008.pdf | 534.52 kB | Adobe PDF | View/Open |
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