Value of blood interferon-γ release assay in early adjuvant diagnosis of tuberculous meningitis / 中国感染控制杂志

ABSTRACT

Objective To evaluate the value of peripheral blood Mycobacterium tuberculosis interferon-γ release assay(TB-IGRA )in early adjuvant diagnosis of tuberculous meningitis(TBM).Methods 56 patients with TBM (trial group) and 56 patients with non-TB meningitis (control group) admitted to West China Hospital of Sichuan University in January-December 2015 were analyzed, results of TB-IGRA, cerebrospinal fluid(CSF) Mycobacterium tuberculosis(MT) culture, and CSF TB-DNA testing of two groups of patients were analyzed, the sensitivity and specificity of each diagnostic method were calculated.Results The sensitivity of TB-IGRA, CSF MT culture, and CSF TB-DNA for diagnosis of TBM were 87.5％(49/56), 19.6％(11/56), and 60.7％(34/56) respectively,specificity were 89.3％(50/56), 100.0％(56/56), and 76.8％(43/56)respectively.The sensitivity of TB-IGRA for diagnosing TBM was higher than that of CSF TB-DNA and CSF MT culture, specificity of TB-IGRA was higher than that of CSF TB-DNA(89.3％>76.8％), pairwise comparison showed a significant difference(all P<0.01).Among 11 cases confirmed by CSF culture, 10 (90.9％[10/11])were positive for TB-IGRA;among 45 cases with clinical diagnosis and effective anti-tuberculosis treatment, 39 (86.7％[39/45])were positive for TB-IGRA.Conclusion TB-IGRA is highly sensitive and specific in the early adjuvant diagnosis of TBM, it is convenient, rapid, effective, and worthy to be popularized in clinical practice.