Nathan Bahr, MD, MA

Nominated From: University of Minnesota

Research Site: Kampala, Uganda

Research Area: Infectious Disease

Primary Mentor: David Boulware, MD, MPH (University of Minnesota)

Research Project

Xpert MTB/RIF Detection of TB Meningitis

Tuberculosis (TB) is an extremely common infection worldwide, one of the disease’s more deadly manifestations if TB meningitis (TBM). In addition to being a condition with high morbidity and mortality, TBM is also very difficult to diagnose. Early diagnosis of TBM leads to better outcomes and so delay in diagnosis is costly to the patient, particularly in terms of recovery of neurologic function should the patient survive the infection. The most commonly used techniques used to diagnose TBM at this time is smear microscopy of the cerebrospinal fluid (CSF) which is seldom positive, and CSF culture for TB which often takes 4-6 weeks to yield a positive result if it does occur. If physicians could diagnose TBM more quickly and more accurately better outcomes for the patients would be very likely.

A new diagnostic system called GeneXpert (Cepheid, Sunnyvale, CA) has been developed to detect tuberculosis in sputum. Typically sputum (mucous coughed up from the lung) is treated with a sample reagent (SR) that is bactericidal and liquefies the sample, it is the loaded into the cartridge and the system automatically works to detect tuberculosis. The test has been endorsed by the World Health Organization for use in respiratory samples and is available in a number of countries, including Uganda. While the GeneXpert system has been used extensively on sputum only small reports have described use on CSF.

We plan to systematically test the GeneXpert system on CSF compared to the current standards in hopes that a more rapid and accurate diagnosis of TB meningitis will prove possible.


Research Significance

Our hope is that this research will lead to quicker and more accurate diagnosis of TB meningitis which in turn may lead to better outcomes for patients with this condition.


Advice for Future Applicants

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