Detection of rifampin resistant tuberculosis meningitis by polymerase chain reaction linked single strand conformation polymorphism analysis of cerebrospinal fluid.

OBJECTIVE To rapidly detect rifampin resistance in Mycobacterium tuberculosis isolates causing meningitis in northeast Iran. METHODS This study presents the results of a polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis for the evaluation of rifampin resistance directly from the CSF of 47 patients strongly suspicious to have tuberculosis meningitis in Emam Reza University Hospital, Mashhad, Iran over 3 years (2002 to 2005). Each CSF sample underwent microscopic examination, culture and DNA amplification by 2 PCR protocols and subsequent detection of mutations by SSCP analysis. RESULTS Among these patients, no mutations were revealed in the rpoB segment by SSCP. CONCLUSION The SSCP analyses of these samples shows complete susceptibility to rifampin. The use of this method can radically reduce the time needed to provide clinicians with data useful in aiding the selection of appropriate drugs.