Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites
Background Xpert™ MTB/Rif is a multiplex hemi-nested real-time PCR-based assay to detect presence of M. tuberculosis within 2 hours of sample collection. The present study aimed at assessing efficacy of Xpert™ MTB/Rif assay for diagnosing peritoneal tuberculosis. Methods Patients with exudative asci...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Bera, Chinmay [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2015 |
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| Schlagwörter: |
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| Anmerkung: |
© Indian Society of Gastroenterology 2015 |
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| Übergeordnetes Werk: |
Enthalten in: Indian Journal of Gastroenterology - Springer-Verlag, 2009, 34(2015), 5 vom: Sept., Seite 395-398 |
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| Übergeordnetes Werk: |
volume:34 ; year:2015 ; number:5 ; month:09 ; pages:395-398 |
| Links: |
|---|
| DOI / URN: |
10.1007/s12664-015-0599-7 |
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| Katalog-ID: |
SPR026659042 |
|---|
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| 520 | |a Background Xpert™ MTB/Rif is a multiplex hemi-nested real-time PCR-based assay to detect presence of M. tuberculosis within 2 hours of sample collection. The present study aimed at assessing efficacy of Xpert™ MTB/Rif assay for diagnosing peritoneal tuberculosis. Methods Patients with exudative ascites, fluid negative for acid-fast bacilli on auramine O fluorescence staining and unyielding fluid cytology for malignant cells, were included. Ultrasound-guided omental biopsy samples were obtained in all. Xpert™ MTB/Rif assay on tissue samples was assessed against a composite “reference” standard for diagnosis of peritoneal tuberculosis, defined as presence of any of the three-culture showing M tuberculosis, granulomatous inflammation on histology or resolution of ascites with 2 months of antitubercular therapy. Results During January 2012–July 2013, 28 patients (age:43 ± 15 years; mean ± SD; male:20) were recruited. Serum ascitic albumin gradient was <1.1 in all except in four patients with underlying cirrhosis. Twenty-one of the 28 patients had peritoneal TB as diagnosed by composite reference standard (histology:18; culture:4; treatment response:3). Seven patients (25 %) had an alternative diagnosis (metastatic carcinoma 2, adenocarcinoma 2, mesothelioma 2, and systemic lupus erythematous 1). Xpert™ MTB/Rif assay was positive in 4/21 patients with peritoneal tuberculosis and in none of the 7 patients with alternative diagnosis. Thus, sensitivity, specificity, positive, and negative predictive values for tissue Xpert™ MTB/Rif assay in diagnosing peritoneal tuberculosis were 19 % (95 % C.I: 6 % to 42 %), 100 % (95 % C.I: 59 % to 100 %), 100 % (40 % to 100 %), and 29 % (95 % C.I: 13 % to 51 %), respectively. Interpretation and conclusion Tissue Xpert™ MTB/Rif assay was of limited use in diagnosing peritoneal tuberculosis. | ||
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| 700 | 1 | |a Ramakrishna, Banumathi |4 aut | |
| 700 | 1 | |a Goel, Ashish |4 aut | |
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10.1007/s12664-015-0599-7 doi (DE-627)SPR026659042 (SPR)s12664-015-0599-7-e DE-627 ger DE-627 rakwb eng Bera, Chinmay verfasserin aut Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2015 Background Xpert™ MTB/Rif is a multiplex hemi-nested real-time PCR-based assay to detect presence of M. tuberculosis within 2 hours of sample collection. The present study aimed at assessing efficacy of Xpert™ MTB/Rif assay for diagnosing peritoneal tuberculosis. Methods Patients with exudative ascites, fluid negative for acid-fast bacilli on auramine O fluorescence staining and unyielding fluid cytology for malignant cells, were included. Ultrasound-guided omental biopsy samples were obtained in all. Xpert™ MTB/Rif assay on tissue samples was assessed against a composite “reference” standard for diagnosis of peritoneal tuberculosis, defined as presence of any of the three-culture showing M tuberculosis, granulomatous inflammation on histology or resolution of ascites with 2 months of antitubercular therapy. Results During January 2012–July 2013, 28 patients (age:43 ± 15 years; mean ± SD; male:20) were recruited. Serum ascitic albumin gradient was <1.1 in all except in four patients with underlying cirrhosis. Twenty-one of the 28 patients had peritoneal TB as diagnosed by composite reference standard (histology:18; culture:4; treatment response:3). Seven patients (25 %) had an alternative diagnosis (metastatic carcinoma 2, adenocarcinoma 2, mesothelioma 2, and systemic lupus erythematous 1). Xpert™ MTB/Rif assay was positive in 4/21 patients with peritoneal tuberculosis and in none of the 7 patients with alternative diagnosis. Thus, sensitivity, specificity, positive, and negative predictive values for tissue Xpert™ MTB/Rif assay in diagnosing peritoneal tuberculosis were 19 % (95 % C.I: 6 % to 42 %), 100 % (95 % C.I: 59 % to 100 %), 100 % (40 % to 100 %), and 29 % (95 % C.I: 13 % to 51 %), respectively. Interpretation and conclusion Tissue Xpert™ MTB/Rif assay was of limited use in diagnosing peritoneal tuberculosis. Granuloma (dpeaa)DE-He213 Omental biopsy (dpeaa)DE-He213 Xpert™ MTB/Rif assay (dpeaa)DE-He213 Michael, Joy Sarojini aut Burad, Deepak aut Shirly, Suzana B aut Gibikote, Sridhar aut Ramakrishna, Banumathi aut Goel, Ashish aut Eapen, C. E. aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 34(2015), 5 vom: Sept., Seite 395-398 (DE-627)SPR02665167X nnns volume:34 year:2015 number:5 month:09 pages:395-398 https://dx.doi.org/10.1007/s12664-015-0599-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 34 2015 5 09 395-398 |
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10.1007/s12664-015-0599-7 doi (DE-627)SPR026659042 (SPR)s12664-015-0599-7-e DE-627 ger DE-627 rakwb eng Bera, Chinmay verfasserin aut Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2015 Background Xpert™ MTB/Rif is a multiplex hemi-nested real-time PCR-based assay to detect presence of M. tuberculosis within 2 hours of sample collection. The present study aimed at assessing efficacy of Xpert™ MTB/Rif assay for diagnosing peritoneal tuberculosis. Methods Patients with exudative ascites, fluid negative for acid-fast bacilli on auramine O fluorescence staining and unyielding fluid cytology for malignant cells, were included. Ultrasound-guided omental biopsy samples were obtained in all. Xpert™ MTB/Rif assay on tissue samples was assessed against a composite “reference” standard for diagnosis of peritoneal tuberculosis, defined as presence of any of the three-culture showing M tuberculosis, granulomatous inflammation on histology or resolution of ascites with 2 months of antitubercular therapy. Results During January 2012–July 2013, 28 patients (age:43 ± 15 years; mean ± SD; male:20) were recruited. Serum ascitic albumin gradient was <1.1 in all except in four patients with underlying cirrhosis. Twenty-one of the 28 patients had peritoneal TB as diagnosed by composite reference standard (histology:18; culture:4; treatment response:3). Seven patients (25 %) had an alternative diagnosis (metastatic carcinoma 2, adenocarcinoma 2, mesothelioma 2, and systemic lupus erythematous 1). Xpert™ MTB/Rif assay was positive in 4/21 patients with peritoneal tuberculosis and in none of the 7 patients with alternative diagnosis. Thus, sensitivity, specificity, positive, and negative predictive values for tissue Xpert™ MTB/Rif assay in diagnosing peritoneal tuberculosis were 19 % (95 % C.I: 6 % to 42 %), 100 % (95 % C.I: 59 % to 100 %), 100 % (40 % to 100 %), and 29 % (95 % C.I: 13 % to 51 %), respectively. Interpretation and conclusion Tissue Xpert™ MTB/Rif assay was of limited use in diagnosing peritoneal tuberculosis. Granuloma (dpeaa)DE-He213 Omental biopsy (dpeaa)DE-He213 Xpert™ MTB/Rif assay (dpeaa)DE-He213 Michael, Joy Sarojini aut Burad, Deepak aut Shirly, Suzana B aut Gibikote, Sridhar aut Ramakrishna, Banumathi aut Goel, Ashish aut Eapen, C. E. aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 34(2015), 5 vom: Sept., Seite 395-398 (DE-627)SPR02665167X nnns volume:34 year:2015 number:5 month:09 pages:395-398 https://dx.doi.org/10.1007/s12664-015-0599-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 34 2015 5 09 395-398 |
| allfields_unstemmed |
10.1007/s12664-015-0599-7 doi (DE-627)SPR026659042 (SPR)s12664-015-0599-7-e DE-627 ger DE-627 rakwb eng Bera, Chinmay verfasserin aut Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2015 Background Xpert™ MTB/Rif is a multiplex hemi-nested real-time PCR-based assay to detect presence of M. tuberculosis within 2 hours of sample collection. The present study aimed at assessing efficacy of Xpert™ MTB/Rif assay for diagnosing peritoneal tuberculosis. Methods Patients with exudative ascites, fluid negative for acid-fast bacilli on auramine O fluorescence staining and unyielding fluid cytology for malignant cells, were included. Ultrasound-guided omental biopsy samples were obtained in all. Xpert™ MTB/Rif assay on tissue samples was assessed against a composite “reference” standard for diagnosis of peritoneal tuberculosis, defined as presence of any of the three-culture showing M tuberculosis, granulomatous inflammation on histology or resolution of ascites with 2 months of antitubercular therapy. Results During January 2012–July 2013, 28 patients (age:43 ± 15 years; mean ± SD; male:20) were recruited. Serum ascitic albumin gradient was <1.1 in all except in four patients with underlying cirrhosis. Twenty-one of the 28 patients had peritoneal TB as diagnosed by composite reference standard (histology:18; culture:4; treatment response:3). Seven patients (25 %) had an alternative diagnosis (metastatic carcinoma 2, adenocarcinoma 2, mesothelioma 2, and systemic lupus erythematous 1). Xpert™ MTB/Rif assay was positive in 4/21 patients with peritoneal tuberculosis and in none of the 7 patients with alternative diagnosis. Thus, sensitivity, specificity, positive, and negative predictive values for tissue Xpert™ MTB/Rif assay in diagnosing peritoneal tuberculosis were 19 % (95 % C.I: 6 % to 42 %), 100 % (95 % C.I: 59 % to 100 %), 100 % (40 % to 100 %), and 29 % (95 % C.I: 13 % to 51 %), respectively. Interpretation and conclusion Tissue Xpert™ MTB/Rif assay was of limited use in diagnosing peritoneal tuberculosis. Granuloma (dpeaa)DE-He213 Omental biopsy (dpeaa)DE-He213 Xpert™ MTB/Rif assay (dpeaa)DE-He213 Michael, Joy Sarojini aut Burad, Deepak aut Shirly, Suzana B aut Gibikote, Sridhar aut Ramakrishna, Banumathi aut Goel, Ashish aut Eapen, C. E. aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 34(2015), 5 vom: Sept., Seite 395-398 (DE-627)SPR02665167X nnns volume:34 year:2015 number:5 month:09 pages:395-398 https://dx.doi.org/10.1007/s12664-015-0599-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 34 2015 5 09 395-398 |
| allfieldsGer |
10.1007/s12664-015-0599-7 doi (DE-627)SPR026659042 (SPR)s12664-015-0599-7-e DE-627 ger DE-627 rakwb eng Bera, Chinmay verfasserin aut Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2015 Background Xpert™ MTB/Rif is a multiplex hemi-nested real-time PCR-based assay to detect presence of M. tuberculosis within 2 hours of sample collection. The present study aimed at assessing efficacy of Xpert™ MTB/Rif assay for diagnosing peritoneal tuberculosis. Methods Patients with exudative ascites, fluid negative for acid-fast bacilli on auramine O fluorescence staining and unyielding fluid cytology for malignant cells, were included. Ultrasound-guided omental biopsy samples were obtained in all. Xpert™ MTB/Rif assay on tissue samples was assessed against a composite “reference” standard for diagnosis of peritoneal tuberculosis, defined as presence of any of the three-culture showing M tuberculosis, granulomatous inflammation on histology or resolution of ascites with 2 months of antitubercular therapy. Results During January 2012–July 2013, 28 patients (age:43 ± 15 years; mean ± SD; male:20) were recruited. Serum ascitic albumin gradient was <1.1 in all except in four patients with underlying cirrhosis. Twenty-one of the 28 patients had peritoneal TB as diagnosed by composite reference standard (histology:18; culture:4; treatment response:3). Seven patients (25 %) had an alternative diagnosis (metastatic carcinoma 2, adenocarcinoma 2, mesothelioma 2, and systemic lupus erythematous 1). Xpert™ MTB/Rif assay was positive in 4/21 patients with peritoneal tuberculosis and in none of the 7 patients with alternative diagnosis. Thus, sensitivity, specificity, positive, and negative predictive values for tissue Xpert™ MTB/Rif assay in diagnosing peritoneal tuberculosis were 19 % (95 % C.I: 6 % to 42 %), 100 % (95 % C.I: 59 % to 100 %), 100 % (40 % to 100 %), and 29 % (95 % C.I: 13 % to 51 %), respectively. Interpretation and conclusion Tissue Xpert™ MTB/Rif assay was of limited use in diagnosing peritoneal tuberculosis. Granuloma (dpeaa)DE-He213 Omental biopsy (dpeaa)DE-He213 Xpert™ MTB/Rif assay (dpeaa)DE-He213 Michael, Joy Sarojini aut Burad, Deepak aut Shirly, Suzana B aut Gibikote, Sridhar aut Ramakrishna, Banumathi aut Goel, Ashish aut Eapen, C. E. aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 34(2015), 5 vom: Sept., Seite 395-398 (DE-627)SPR02665167X nnns volume:34 year:2015 number:5 month:09 pages:395-398 https://dx.doi.org/10.1007/s12664-015-0599-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 34 2015 5 09 395-398 |
| allfieldsSound |
10.1007/s12664-015-0599-7 doi (DE-627)SPR026659042 (SPR)s12664-015-0599-7-e DE-627 ger DE-627 rakwb eng Bera, Chinmay verfasserin aut Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Indian Society of Gastroenterology 2015 Background Xpert™ MTB/Rif is a multiplex hemi-nested real-time PCR-based assay to detect presence of M. tuberculosis within 2 hours of sample collection. The present study aimed at assessing efficacy of Xpert™ MTB/Rif assay for diagnosing peritoneal tuberculosis. Methods Patients with exudative ascites, fluid negative for acid-fast bacilli on auramine O fluorescence staining and unyielding fluid cytology for malignant cells, were included. Ultrasound-guided omental biopsy samples were obtained in all. Xpert™ MTB/Rif assay on tissue samples was assessed against a composite “reference” standard for diagnosis of peritoneal tuberculosis, defined as presence of any of the three-culture showing M tuberculosis, granulomatous inflammation on histology or resolution of ascites with 2 months of antitubercular therapy. Results During January 2012–July 2013, 28 patients (age:43 ± 15 years; mean ± SD; male:20) were recruited. Serum ascitic albumin gradient was <1.1 in all except in four patients with underlying cirrhosis. Twenty-one of the 28 patients had peritoneal TB as diagnosed by composite reference standard (histology:18; culture:4; treatment response:3). Seven patients (25 %) had an alternative diagnosis (metastatic carcinoma 2, adenocarcinoma 2, mesothelioma 2, and systemic lupus erythematous 1). Xpert™ MTB/Rif assay was positive in 4/21 patients with peritoneal tuberculosis and in none of the 7 patients with alternative diagnosis. Thus, sensitivity, specificity, positive, and negative predictive values for tissue Xpert™ MTB/Rif assay in diagnosing peritoneal tuberculosis were 19 % (95 % C.I: 6 % to 42 %), 100 % (95 % C.I: 59 % to 100 %), 100 % (40 % to 100 %), and 29 % (95 % C.I: 13 % to 51 %), respectively. Interpretation and conclusion Tissue Xpert™ MTB/Rif assay was of limited use in diagnosing peritoneal tuberculosis. Granuloma (dpeaa)DE-He213 Omental biopsy (dpeaa)DE-He213 Xpert™ MTB/Rif assay (dpeaa)DE-He213 Michael, Joy Sarojini aut Burad, Deepak aut Shirly, Suzana B aut Gibikote, Sridhar aut Ramakrishna, Banumathi aut Goel, Ashish aut Eapen, C. E. aut Enthalten in Indian Journal of Gastroenterology Springer-Verlag, 2009 34(2015), 5 vom: Sept., Seite 395-398 (DE-627)SPR02665167X nnns volume:34 year:2015 number:5 month:09 pages:395-398 https://dx.doi.org/10.1007/s12664-015-0599-7 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER AR 34 2015 5 09 395-398 |
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Twenty-one of the 28 patients had peritoneal TB as diagnosed by composite reference standard (histology:18; culture:4; treatment response:3). Seven patients (25 %) had an alternative diagnosis (metastatic carcinoma 2, adenocarcinoma 2, mesothelioma 2, and systemic lupus erythematous 1). Xpert™ MTB/Rif assay was positive in 4/21 patients with peritoneal tuberculosis and in none of the 7 patients with alternative diagnosis. Thus, sensitivity, specificity, positive, and negative predictive values for tissue Xpert™ MTB/Rif assay in diagnosing peritoneal tuberculosis were 19 % (95 % C.I: 6 % to 42 %), 100 % (95 % C.I: 59 % to 100 %), 100 % (40 % to 100 %), and 29 % (95 % C.I: 13 % to 51 %), respectively. 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| author |
Bera, Chinmay |
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Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites Granuloma (dpeaa)DE-He213 Omental biopsy (dpeaa)DE-He213 Xpert™ MTB/Rif assay (dpeaa)DE-He213 |
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Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites |
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Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites |
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Indian Journal of Gastroenterology |
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2015 |
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Bera, Chinmay Michael, Joy Sarojini Burad, Deepak Shirly, Suzana B Gibikote, Sridhar Ramakrishna, Banumathi Goel, Ashish Eapen, C. E. |
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Bera, Chinmay |
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10.1007/s12664-015-0599-7 |
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tissue xpert™ mtb/rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites |
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Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites |
| abstract |
Background Xpert™ MTB/Rif is a multiplex hemi-nested real-time PCR-based assay to detect presence of M. tuberculosis within 2 hours of sample collection. The present study aimed at assessing efficacy of Xpert™ MTB/Rif assay for diagnosing peritoneal tuberculosis. Methods Patients with exudative ascites, fluid negative for acid-fast bacilli on auramine O fluorescence staining and unyielding fluid cytology for malignant cells, were included. Ultrasound-guided omental biopsy samples were obtained in all. Xpert™ MTB/Rif assay on tissue samples was assessed against a composite “reference” standard for diagnosis of peritoneal tuberculosis, defined as presence of any of the three-culture showing M tuberculosis, granulomatous inflammation on histology or resolution of ascites with 2 months of antitubercular therapy. Results During January 2012–July 2013, 28 patients (age:43 ± 15 years; mean ± SD; male:20) were recruited. Serum ascitic albumin gradient was <1.1 in all except in four patients with underlying cirrhosis. Twenty-one of the 28 patients had peritoneal TB as diagnosed by composite reference standard (histology:18; culture:4; treatment response:3). Seven patients (25 %) had an alternative diagnosis (metastatic carcinoma 2, adenocarcinoma 2, mesothelioma 2, and systemic lupus erythematous 1). Xpert™ MTB/Rif assay was positive in 4/21 patients with peritoneal tuberculosis and in none of the 7 patients with alternative diagnosis. Thus, sensitivity, specificity, positive, and negative predictive values for tissue Xpert™ MTB/Rif assay in diagnosing peritoneal tuberculosis were 19 % (95 % C.I: 6 % to 42 %), 100 % (95 % C.I: 59 % to 100 %), 100 % (40 % to 100 %), and 29 % (95 % C.I: 13 % to 51 %), respectively. Interpretation and conclusion Tissue Xpert™ MTB/Rif assay was of limited use in diagnosing peritoneal tuberculosis. © Indian Society of Gastroenterology 2015 |
| abstractGer |
Background Xpert™ MTB/Rif is a multiplex hemi-nested real-time PCR-based assay to detect presence of M. tuberculosis within 2 hours of sample collection. The present study aimed at assessing efficacy of Xpert™ MTB/Rif assay for diagnosing peritoneal tuberculosis. Methods Patients with exudative ascites, fluid negative for acid-fast bacilli on auramine O fluorescence staining and unyielding fluid cytology for malignant cells, were included. Ultrasound-guided omental biopsy samples were obtained in all. Xpert™ MTB/Rif assay on tissue samples was assessed against a composite “reference” standard for diagnosis of peritoneal tuberculosis, defined as presence of any of the three-culture showing M tuberculosis, granulomatous inflammation on histology or resolution of ascites with 2 months of antitubercular therapy. Results During January 2012–July 2013, 28 patients (age:43 ± 15 years; mean ± SD; male:20) were recruited. Serum ascitic albumin gradient was <1.1 in all except in four patients with underlying cirrhosis. Twenty-one of the 28 patients had peritoneal TB as diagnosed by composite reference standard (histology:18; culture:4; treatment response:3). Seven patients (25 %) had an alternative diagnosis (metastatic carcinoma 2, adenocarcinoma 2, mesothelioma 2, and systemic lupus erythematous 1). Xpert™ MTB/Rif assay was positive in 4/21 patients with peritoneal tuberculosis and in none of the 7 patients with alternative diagnosis. Thus, sensitivity, specificity, positive, and negative predictive values for tissue Xpert™ MTB/Rif assay in diagnosing peritoneal tuberculosis were 19 % (95 % C.I: 6 % to 42 %), 100 % (95 % C.I: 59 % to 100 %), 100 % (40 % to 100 %), and 29 % (95 % C.I: 13 % to 51 %), respectively. Interpretation and conclusion Tissue Xpert™ MTB/Rif assay was of limited use in diagnosing peritoneal tuberculosis. © Indian Society of Gastroenterology 2015 |
| abstract_unstemmed |
Background Xpert™ MTB/Rif is a multiplex hemi-nested real-time PCR-based assay to detect presence of M. tuberculosis within 2 hours of sample collection. The present study aimed at assessing efficacy of Xpert™ MTB/Rif assay for diagnosing peritoneal tuberculosis. Methods Patients with exudative ascites, fluid negative for acid-fast bacilli on auramine O fluorescence staining and unyielding fluid cytology for malignant cells, were included. Ultrasound-guided omental biopsy samples were obtained in all. Xpert™ MTB/Rif assay on tissue samples was assessed against a composite “reference” standard for diagnosis of peritoneal tuberculosis, defined as presence of any of the three-culture showing M tuberculosis, granulomatous inflammation on histology or resolution of ascites with 2 months of antitubercular therapy. Results During January 2012–July 2013, 28 patients (age:43 ± 15 years; mean ± SD; male:20) were recruited. Serum ascitic albumin gradient was <1.1 in all except in four patients with underlying cirrhosis. Twenty-one of the 28 patients had peritoneal TB as diagnosed by composite reference standard (histology:18; culture:4; treatment response:3). Seven patients (25 %) had an alternative diagnosis (metastatic carcinoma 2, adenocarcinoma 2, mesothelioma 2, and systemic lupus erythematous 1). Xpert™ MTB/Rif assay was positive in 4/21 patients with peritoneal tuberculosis and in none of the 7 patients with alternative diagnosis. Thus, sensitivity, specificity, positive, and negative predictive values for tissue Xpert™ MTB/Rif assay in diagnosing peritoneal tuberculosis were 19 % (95 % C.I: 6 % to 42 %), 100 % (95 % C.I: 59 % to 100 %), 100 % (40 % to 100 %), and 29 % (95 % C.I: 13 % to 51 %), respectively. Interpretation and conclusion Tissue Xpert™ MTB/Rif assay was of limited use in diagnosing peritoneal tuberculosis. © Indian Society of Gastroenterology 2015 |
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Tissue Xpert™ MTB/Rif assay is of limited use in diagnosing peritoneal tuberculosis in patients with exudative ascites |
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Michael, Joy Sarojini Burad, Deepak Shirly, Suzana B Gibikote, Sridhar Ramakrishna, Banumathi Goel, Ashish Eapen, C. E. |
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