TY - JOUR T1 - 与结核病的儿童免疫为主和微生物学的检测性能脑膜炎欧洲 - 多中心儿科结核病网络的欧洲试验组（ptbnet）研究JF - 欧洲呼吸杂志JO - EUR呼吸杂志DO - 10.1183 / 13993003.02004-2019 SP - 1902004 AU - 八宿罗伊，Robindra AU - 你，欧铠淳 - 的Blazquez - 加梅罗，丹尼尔AU - 猎鹰Neyra，萝拉AU - NETH，奥拉夫AU - 诺格拉朱利安，安东尼AU - 利洛，克里斯蒂娜AU - 加利，路易莎AU - 文图里尼，伊丽莎白AU - Buonsenso，达尼罗AU - Götzinger，弗洛里安AU - 马丁内斯-Alier，艳女AU - Velizarova，斯韦特兰娜AU - 布林克曼，福尔克AU - 韦尔奇，史蒂芬B. AU - Tsolia，玛丽亚AU - Santiago-加西亚，贝戈尼亚AU - 克鲁格，雷娜特AU - Tebruegge，马克A2 - ，Y1 - 2020年1月1日UR - //www.qdcxjkg.com/content/early/2020/03/12/13993003.02004-2019.abstractN2 - 介绍结核性脑膜炎（TBM）经常被诊断挑战。在干扰素-γ释放试验（IGRA）和分子检测的儿童在日常临床实践的性能与TBM只有有限的数据存在，特别是在涉及27家医疗机构对结核病儿童提供照顾欧洲setting.Methods多中心，回顾性研究（包括，54（45.8％）TB）在九个欧洲countries.Results 118名儿童中有明确，38（32.2％）可能和26（22.0％）可能TBM;39（33.1％）有TBM 1级，68（57.6％）2级和11（9.3％）3级。108例谁接受颅成像90（83.3％）有≥1异常发现与TBM一致。At the 5 mm cut-off the tuberculin skin test had a sensitivity of 61.9% (95%CI: 51.2–71.6%); 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%), and CSF polymerase-chain-reaction (PCR) in 34.8% (95%CI: 22.9–43.7%). In the subgroup of children who had TST, IGRA, CSF culture and CSF PCR performed 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.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: RB was a consultant for FIND, Geneva, a non-profit organization, from 2014 to 2016.Conflict of interest: Dr. Thee has nothing to disclose.Conflict of interest: Dr. Blázquez-Gamero has nothing to disclose.Conflict of interest: Dr. Falcón-Neyra has nothing to disclose.Conflict of interest: Dr. Neth has nothing to disclose.Conflict of interest: Dr. Noguera-Julian has nothing to disclose.Conflict of interest: Dr. Lillo has nothing to disclose.Conflict of interest: Dr. Galli has nothing to disclose.Conflict of interest: Dr. Venturini has nothing to disclose.Conflict of interest: Dr. Buonsenso has nothing to disclose.Conflict of interest: Dr. Götzinger has nothing to disclose.Conflict of interest: Dr. Martinez-Alier has nothing to disclose.Conflict of interest: Dr. Velizarova has nothing to disclose.Conflict of interest: Dr. Brinkmann has nothing to disclose.Conflict of interest: Dr. Welch has nothing to disclose.Conflict of interest: Dr. Tsolia has nothing to disclose.Conflict of interest: Dr Santiago-Garcia has received diagnostic assays free of charge for other projects from Cepheid, and support for conference attendance from GlaxoSmithKline.Conflict of interest: Dr. Krüger has nothing to disclose.Conflict of interest: Dr Tebruegge has received QuantiFERON assays at reduced pricing or free of charge for other TB diagnostics projects from the manufacturer (Cellestis/Qiagen), and has received support for conference attendance from Cepheid ER -