       Document 1066
 DOCN  M9621066
 TI    Nested polymerase chain reaction for diagnosis and monitoring treatment
       response in AIDS patients with tuberculous meningitis.
 DT    9602
 AU    Scarpellini P; Racca S; Cinque P; Delfanti F; Gianotti N; Terreni MR;
       Vago L; Lazzarin A; Infectious Diseases Department, San Raffaele
       Scientific; Institute, Milan, Italy.
 SO    AIDS. 1995 Aug;9(8):895-900. Unique Identifier : AIDSLINE MED/96014963
 AB    OBJECTIVE: To investigate the usefulness of polymerase chain reaction
       (PCR) from cerebrospinal fluid (CSF) for rapid diagnosis and assessing
       treatment response of tuberculous meningitis (TBM) in AIDS patients.
       PATIENTS: Forty-four CSF samples from 10 patients with TBM confirmed by
       autopsy or by a culture of CSF (41 samples) and from two patients with
       highly probable TBM (three samples) were analysed. CSF specimens were
       collected before and during standard antituberculous treatment. CSF
       samples from 24 AIDS patients with autopsy evidence of other neurologic
       diseases were studied as controls. METHODS: A nested PCR amplifying a
       123 base-pair fragment of the IS6110 sequence was developed. Heating to
       95 degrees C for 15 min was used for pre-PCR treatment of samples.
       RESULTS: Detection limit was 10(2) colony-forming units per ml or 10 fg
       purified Mycobacterium tuberculosis DNA. M.tuberculosis DNA was detected
       in CSF from all the 12 confirmed or highly probable TBM cases. CSF was
       positive by nested PCR in 17 of 17 (100%) and 18 of 27 (67%) samples
       collected before and during therapy, respectively. Clinical and
       microbiological follow-up > or = 2 weeks was available for seven
       patients. PCR-positive CSF converted to M. tuberculosis DNA negative in
       four patients that showed improvement during treatment, but it remained
       positive in three patients who died of disseminated tuberculosis. All
       the CSF samples from the non-TBM controls were negative by nested PCR.
       CONCLUSIONS: Nested PCR for detection of M. tuberculosis DNA is specific
       for diagnosis of TBM and more sensitive than conventional bacteriology.
       Moreover, nested PCR could be a useful method for assessing treatment
       response in AIDS patients with TBM.
 DE    AIDS-Related Opportunistic Infections/*DIAGNOSIS/MICROBIOLOGY  Base
       Sequence  Case Report  DNA Primers/GENETICS  DNA,
       Bacterial/CEREBROSPINAL FLUID/GENETICS  Evaluation Studies  Human
       Molecular Sequence Data  Mycobacterium tuberculosis/GENETICS/ISOLATION &
       PURIF  Polymerase Chain Reaction/*METHODS/STATISTICS & NUMER DATA
       Sensitivity and Specificity  Tuberculosis,
       Meningeal/*COMPLICATIONS/*DIAGNOSIS/MICROBIOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

