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We prospectively enrolled patients in whom TBM was considered in Shaanxi Province, northwestern China, over a 2-year period (September 2010 to December 2012). Cerebrospinal fluid specimens were cultured for <jats:italic>Mycobacterium tuberculosis<\/jats:italic>; with phenotypic and genotypic drug susceptibility testing (DST), as well as genotyping of all positive cultures. Among 350 patients included in the study, 27 (7.7%) had culture-confirmed TBM; 84 (24.0%) had probable and 239 (68.3%) had possible TBM. DST was performed on 25\/27 (92.3%) culture positive specimens; 12\/25 (48.0%) had \u201cany resistance\u201d detected and 3 (12.0%) were multi-drug resistant (MDR). Demographic and clinical features of drug resistant and drug susceptible TBM cases were similar. Beijing was the most common genotype (20\/25; 80.0%) with 9\/20 (45%) of the Beijing strains exhibiting drug resistance; including all 3 MDR strains. All (4\/4) isoniazid resistant strains had mutations in the <jats:italic>katG<\/jats:italic> gene; 75% (3\/4) of strains with phenotypic rifampicin resistance had mutations in the <jats:italic>rpoB<\/jats:italic> gene detected by Xpert MTB\/RIF\u00ae. High rates of drug resistance were found among culture-confirmed TBM cases; most were Beijing strains.<\/jats:p>","DOI":"10.1038\/srep25251","type":"journal-article","created":{"date-parts":[[2016,5,4]],"date-time":"2016-05-04T09:27:46Z","timestamp":1462354066000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["High rate of drug resistance among tuberculous meningitis cases in Shaanxi province, China"],"prefix":"10.1038","volume":"6","author":[{"given":"Ting","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guo-Dong","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Pang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia-Yun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Ning","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"Dai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-Ping","family":"Zhan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben J","family":"Marais","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan-Lin","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2016,5,4]]},"reference":[{"key":"BFsrep25251_CR1","doi-asserted-by":"publisher","first-page":"1101","DOI":"10.2217\/fmb.12.86","volume":"7","author":"F Brancusi","year":"2012","unstructured":"Brancusi, F., Farrar, J. & Heemskerk, D. 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