ABSTRACT
Meningitis is a severe and potentially fatal form of tuberculosis. The diagnostic workup involves detection of acid-fast bacilli (AFB) in the cerebrospinal fluid (CSF) by microscopy or culture, however, the difficulty in detecting the organism poses a challenge to diagnosis. The use of the polymerase chain reaction (PCR) in the diagnostic approach to Mycobacterium tuberculosis (MTB) meningitis has been reported as a fast and accurate method, with several commercial kits available. As an alternative, some institutions have been developing inexpensive in house assays. In our institution, we use an in house PCR for tuberculosis. We analyzed the performance of our PCR for the diagnosis of MTB meningitis in 148 consecutive patients, using MTB culture as gold standard. The sensitivity and specificity of CSF PCR for the diagnosis of MTB meningitis was 50 percent and 98.6 percent respectively with a concordance with CSF mycobacterial culture of 96 percent (Kappa=0.52). In contrast to CSF cultures for MTB, our PCR test is a fast, simple and inexpensive tool to diagnose tuberculous meningitis with a performance similar to that obtained with the available commercial kits.
Subject(s)
Adult , Female , Humans , Male , Mycobacterium tuberculosis/genetics , Polymerase Chain Reaction , Tuberculosis, Meningeal/diagnosis , Bacterial Typing Techniques , Mycobacterium tuberculosis/isolation & purification , Predictive Value of Tests , Reagent Kits, Diagnostic , Reproducibility of Results , Sensitivity and Specificity , Tuberculosis, Meningeal/cerebrospinal fluidABSTRACT
OBJECTIVE: To determine the prevalence of congenital cytomegalovirus infection in newborn infants admitted to an intensive care unit in a public hospital in Porto Alegre. METHODS: A cross-sectional study of 261 newborn infants born at a public hospital in the city of Porto Alegre in 2003 and admitted to the intensive care ward. Urine samples were collected within 7 days of birth and a polymerase chain reaction-PCR performed to test for cytomegalovirus DNA. RESULTS: The prevalence of congenital cytomegalovirus infection among the study population was 0.8% (95% CI: 0.097%-2.86%). It was not possible to assess risk factors because this prevalence was so low. CONCLUSIONS: The prevalence of congenital cytomegalovirus infection in an intensive care unit at a public hospital in Porto Alegre was not considered elevated and was comparable with prevalence rates found by other studies.