English

Abstract

INTRODUCTION: Early laboratory diagnosis of tuberculous peritonitis (TBP) is crucial to start antitubercular chemotherapy and to prevent its complications. However conventional methods are either less sensitive or time consuming. Hence the diagnostic potential of BacT/ALERT and polymerase chain reaction (PCR) was evaluated in this study. MATERIAL AND METHOD : The study group comprised of 21 cases and nine controls. The cases were divided into confirmed sub group (seven cases) - smear or culture or histopathologically proven and probable subgroup (fourteen cases) - clinically suspected cases. Ziehl Neelsen (ZN), Auramine Phenol (AP) staining, Lowenstein Jensen (LJ) culture, BacT/ALERT and nested Polymerase chain reaction (PCR) targeting IS6110 were carried out on all the patients. RESULTS: Sensitivity of ZN, AP staining and LJ culture were found to be 23.8%, 28.5% and 57.1% respectively. Whereas BacT/ALERT and nested PCR showed a sensitivity of 76.1% and 90.4% respectively. The mean detection time of growth by LJ culture was 32.10 days where as that of BacT/ALERT was 21.28 days. The contamination rates in LJ culture and BacT/ALERT were 5.0%% and 10.0% respectively. CONCLUSION: Nested PCR and BacT/ALERT found to be more sensitive compared to LJ culture and smear microscopy. BacT/ALERT detects mycobacterial growth at a faster rate with less contamination rate compared to LJ culture. As both false negative and false positive results are reported on nested PCR, so alone it should not be used as a criterion for initiating or terminating the therapy but should be supported by