title: Development and evaluation of multiplex PCR in rapid diagnosis of abdominal tuberculosis.
abstract: The clinical features of abdominal tuberculosis (TB) are non-specific and establishing a diagnosis remains a challenge. A delay in diagnosis is likely to increase the morbidity in these patients. We developed a multiplex polymerase chain reaction (PCR) using 16SrRNA, IS6110, and devR, and evaluated it in comparison with other conventional tests in clinical suspects of abdominal TB. A total of 183 patients with clinical suspicion of abdominal TB (96 patients with intestinal TB and 87 with peritoneal TB) were enrolled for the study. Endoscopic or intraoperative biopsies were collected from patients suspected of intestinal TB and ascitic fluid was collected from patients with a suspicion of peritoneal TB. Of the intestinal tuberculosis group, there were 40 confirmed cases and 56 controls, while of the peritoneal tuberculosis group there were 37 confirmed cases and 50 controls. Multiplex PCR showed a high sensitivity and specificity in both the intestinal TB and peritoneal TB groups. When combined with histopathology, multiplex PCR could detect 97.5% of all the cases in the intestinal tuberculosis group, while in combination adenosine deaminase levels (ADA) in cases of peritoneal tuberculosis it increased the specificity of diagnosis of peritoneal tuberculosis to 95%. In combination with histopathology in suspected intestinal TB cases, and ADA testing in suspected peritoneal TB cases, it can be used as a highly sensitive, specific, and rapid diagnostic tool with the ability to supplement the limitations of other diagnostic modalities.
authors.affiliation: Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Vinaykumar
authors.initials: V
authors.lastname: Hallur
authors.forename: Meera
authors.initials: M
authors.lastname: Sharma
authors.forename: Sunil
authors.initials: S
authors.lastname: Sethi
authors.forename: Kusum
authors.initials: K
authors.lastname: Sharma
authors.forename: Abhishek
authors.initials: A
authors.lastname: Mewara
authors.forename: Sunil
authors.initials: S
authors.lastname: Dhatwalia
authors.forename: Rakesh
authors.initials: R
authors.lastname: Yadav
authors.forename: Deepak
authors.initials: D
authors.lastname: Bhasin
authors.forename: Saroj Kant
authors.initials: SK
authors.lastname: Sinha
authors.forename: Satyawati
authors.initials: S
authors.lastname: Rana
authors.forename: Kusum
authors.initials: K
authors.lastname: Joshi
mesh_terms: D000243:Adenosine Deaminase / Q000032:analysis; D000293:Adolescent; D000328:Adult; D001202:Ascitic Fluid / Q000737:chemistry; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction / Q000379:methods*; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D014395:Peritonitis, Tuberculous / Q000175:diagnosis*; D012336:RNA, Ribosomal, 16S / Q000302:isolation & purification; D012680:Sensitivity and Specificity; D017422:Sequence Analysis, DNA; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S; D000243:Adenosine Deaminase