Diagnostic value of rifampin resistance real-time fluorescent quantitative nucleic acid amplification technology combined with T cell spot test of tuberculosis infection in tuberculous meningitis / 中国医师进修杂志

ABSTRACT

Objective:To evaluate the diagnostic value of rifampin resistance real-time fluorescent quantitative nucleic acid amplification technology (GeneXpert) combined with T cell spot test of tuberculosis infection (T-SPOT.TB) in tuberculous meningitis (TBM).Methods:The clinical data of 70 TBM patients (TBM group) and 30 non-TBM patients (non-TBM group) in Shenyang Chest Hospital from March 2017 to December 2019 were retrospectively analyzed. All patients were detected by GeneXpert and T-SPOT.TB. The results of MGIT960 liquid culture of cerebrospinal fluid were used as the gold standard to evaluate the diagnosis of TBM by GeneXpert and T-SPOT.TB.Results:The positive rates of GeneXpert and T-SPOT.TB in parallel and in series in TBM group were significantly higher than those in non-TBM group 27.14% (19/70) vs. 0, 72.86% (51/70) vs. 46.67% (14/30), 78.57% (55/70) vs. 46.67% (14/30) and 21.43% (15/70) vs. 0, and there were statistical differences ( P<0.01 or <0.05). The sensitivity and accuracy of two methods in parallel in TBM diagnosis were 78.57% and 71.00% respectively. The specificity and misdiagnosis rate of two methods in series in TBM diagnosis were 100.00% and 0 respectively. Conclusions:The sensitivity of GeneXpert and T-SPOT.TB in parallel is the highest in TBM diagnosis. The specificity of the two methods in series and GeneXpert alone is as high as 100.00%. The two methods can reduce the misdiagnosis rate of TBM in series and reduce the rate of missed diagnosis in parallel.