TY - T1的儿童免疫和微生物测试的性能与结核脑膜炎在欧洲——多中心儿科结核病网络欧洲试验集团(ptbnet)研究JF -欧洲呼吸杂志乔-和J欧元做10.1183/13993003.02004 -2019 SP - 1902004 AU - Robindra苏罗伊AU -斯蒂芬妮你非盟-丹尼尔Blazquez-Gamero盟洛拉Falcon-Neyra AU -奥拉夫Neth AU -安东尼Noguera-Julian AU -克里斯蒂娜签约Elisabetta Venturini AU -路易莎加利盟盟-达尼洛Buonsenso AU - Florian Gotzinger盟Nuria Martinez-Alier AU -斯维特拉娜Velizarova AU - Folke Brinkmann盟史蒂文·b·韦尔奇AU -玛丽亚Tsolia盟Begona Santiago-Garcia AU -克鲁格雷盟- Marc Tebruegge A2, Y1 - 2020/01/01 UR - //www.qdcxjkg.com/content/early/2020/03/12/13993003.02004 - 2019. -抽象N2 -介绍结核性脑膜炎(TBM)往往是诊断挑战。只有有限的数据存在于移行细胞释放的性能检测(干扰素释放)和分子检测在儿童与TBM在日常临床实践中,特别是在欧洲。方法多中心回顾性研究涉及27个医疗机构提供照顾孩子在欧洲九个国家的肺结核(TB)。结果,包括118名儿童,54(45.8%)有明确的,38(32.2%)可能和26(22.0%)可能TBM;39 (33.1%)TBM 1级,68(57.6%)2级和11(9.3%)三年级。108病人颅成像90(83.3%)≥1异常寻找与TBM一致。在5毫米切断结核菌素皮肤试验的敏感性为61.9%(95%置信区间ci: 51.2 - -71.6%);在10毫米截止50.0%(95%置信区间ci: 40.0 - -60.0%)。测试敏感性QuantiFERON-TB T-SPOT。结核病化验了71.7%(95%置信区间ci: 58.4 - -82.1%)和82.5% (95% ci: 58.2—-94.6%),分别为(p = 0.53)。不确定的结果是常见的,发生在17.0%的QuantiFERON-TB化验。脑脊液(CSF)文化是积极的,50.0% (95% ci: 40.1—-59.9%),和脑脊液聚合酶链反应(PCR) 34.8%(95%置信区间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 -