Tissue XpertTM 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.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In peritoneal tissue, Xpert MTB/RIF sensitivity against culture was 50% (7 to 93).
“In peritoneal tissue, Xpert MTB/RIF sensitivity and specificity against culture were 50% (7 to 93) and 92% (73 to 99) (1 study; 28 participants; Bera 2015); Appendix 10.”
From Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults (2021) · cites this paper as Bera 2015
In peritoneal tissue, Xpert MTB/RIF specificity against culture was 92% (73 to 99).
“In peritoneal tissue, Xpert MTB/RIF sensitivity and specificity against culture were 50% (7 to 93) and 92% (73 to 99) (1 study; 28 participants; Bera 2015); Appendix 10.”
From Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults (2021) · cites this paper as Bera 2015
Cites
Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults
Steingart, K. R., Schiller, I., Horne, D. J. D. L., Pai, M., Boehme, C. C., & Dendukuri, N. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009593.pub3 · Cited by 1,147 · see citing works
Boehme, C. C., Nicol, M. P., Nabeta, P., Michael, J. S., Gotuzzo, E., Tahirli, R., Gler, M. T., Blakemore, R., Worodria, W. O., Gray, C. M., et al. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60438-8 · Cited by 1,007 · see citing works
Self-citationHelb, D., Jones, M., Story, E., Boehme, C., Wallace, E., Ho, K., Kop, J., Owens, M. R., Rodgers, R., Banada, P., et al. (2010) · Journal of Clinical Microbiology · doi:10.1128/jcm.01463-09 · Cited by 914 · see citing works
Sleisenger and Fordtran's gastrointestinal and liver disease
Feldman, E. B. M., Friedman, L. S., & Brandt, L. J. (2015) · Elsevier eBooks · Cited by 638 · see citing works
Evaluation of the analytical performance of the Xpert MTB/RIF assay
Blakemore, R., Story, E., Helb, D., Kop, J., Banada, P., Owens, M. R., Chakravorty, S., Jones, M., & Alland, D. (2010) · Journal of Clinical Microbiology · doi:10.1128/jcm.00128-10 · Cited by 485 · see citing works
Rapid Molecular Detection of Extrapulmonary Tuberculosis by the Automated GeneXpert MTB/RIF System
Hillemann, D., Rüsch-Gerdes, S., Boehme, C., & Richter, E. (2011) · Journal of Clinical Microbiology · doi:10.1128/jcm.02268-10 · Cited by 413 · see citing works
Clinical validation of Xpert MTB/RIF for the diagnosis of extrapulmonary tuberculosis
Tortoli, E., Russo, C., Piersimoni, C., Mazzola, E., Dal Monte, P., Pascarella, M., Borroni, E., Mondo, A., Piana, F., Scarparo, C., et al. (2012) · European Respiratory Journal · doi:10.1183/09031936.00176311 · Cited by 322 · see citing works
Foundation for Innovative New Diagnostics
(2009) · Springer eBooks · doi:10.1007/978-0-387-78665-0_5669 · Cited by 144 · see citing works
Tuberculous peritonitis – reports of 26 cases, detailing diagnostic and therapeutic problems
Demir, K., Ökten, A., Kaymakoğlu, S., et al. (2001) · European Journal of Gastroenterology & Hepatology · doi:10.1097/00042737-200105000-00019 · Cited by 140 · see citing works
Ascites and Spontaneous Bacterial Peritonitis
Runyon, B. A. (2011) · Wiley eBooks · doi:10.1002/9781119950509.ch17 · Cited by 113 · see citing works
Vardareli, E., Kebapçı, M., Sarıçam, T., et al. (2004) · Digestive and Liver Disease · doi:10.1016/j.dld.2003.10.016 · Cited by 82 · see citing works
Sharma, S. K., Kohli, M., Chaubey, J., Yadav, R. N., Sharma, R., Singh, B. K., Sreenivas, V., Sharma, A., Bhatia, R., Jain, D., et al. (2014) · European Respiratory Journal · doi:10.1183/09031936.00059014 · Cited by 78 · see citing works
Performance of Xpert MTB/RIF on pleural tissue for the diagnosis of pleural tuberculosis
Christopher, D. J., Schumacher, S. G., Michael, J. S., Luo, R., Balamugesh, T., Duraikannan, P., Pollock, N. R., Pai, M., & Denkinger, C. M. (2013) · European Respiratory Journal · doi:10.1183/09031936.00103213 · Cited by 60 · see citing works
Self-citationExtra Pulmonary Tuberculosis: A Diagnostic Dilemma
Jain, A. (2011) · Indian Journal of Clinical Biochemistry · doi:10.1007/s12291-010-0104-0 · Cited by 39 · see citing works
Presenting Experience of Managing Abdominal Tuberculosis at a Tertiary Care Hospital in India
Mandal, A., Das, S. K., & Bairagya, T. D. (2011) · Journal of Global Infectious Diseases · doi:10.4103/0974-777x.91055 · Cited by 8 · see citing works
The Manual of Standard Operating Procedures
Palmer, D. (1961) · Journal of Communication · doi:10.1111/j.1460-2466.1961.tb00335.x · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Xpert <sup>®</sup> MTB/RIF assay for extrapulmonary tuberculosis and rifampicin resistance
Kohli, M., Schiller, I., Dendukuri, N., Dheda, K., Denkinger, C. M., Schumacher, S. G., & Steingart, K. R. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012768.pub2 · Cited by 245 · see citing works
Kohli, M., Schiller, I., Dendukuri, N., Yao, M., Dheda, K., Denkinger, C. M., Schumacher, S. G., & Steingart, K. R. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012768.pub3 · Cited by 215 · see citing works
- Authors
- Bera, C., Michael, J. S., Burad, D., Shirly, S. B., Gibikote, S., Ramakrishna, B., Goel, A., & Eapen, C. E.
- Affiliations
- Christian Medical College, Vellore (IN)
- Corresponding author
- Goel, Ashish
- Venue
- Indian Journal of Gastroenterology
- Published
- 2015-09
- Volume
- 34
- Issue
- 5
- Pages
- 395-398
- ISSN
- 0254-8860 (ISSN-L)
- 0975-0711
- OpenAlex
- W2245595014
- Cited by
- 25
- References
- 16
- Citations by year
- 2026: 1 · 2025: 4 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 2
- FWCI
- 1.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Indian Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Institutiona fluid research fund, Christian Medical College (IRB Min. No. 7911)
- Topics
- Health Sciences › Medicine › Surgery › Diagnosis and treatment of tuberculosis
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
- Keywords
- tuberculous peritonitis, exudative ascites, Xpert MTB/RIF, Mycobacterium tuberculosis detection, diagnostic accuracy, omental biopsy, sensitivity and specificity, differential diagnosis of ascites
- MeSH terms
- Adult, Ascites, Exudates and Transudates, Female, Humans, Male, Middle Aged, Mycobacterium tuberculosis, Omentum, Sensitivity and Specificity, Time Factors, Peritonitis, Tuberculous, Real-Time Polymerase Chain Reaction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
