“Induced sputum versus gastric lavage for the diagnosis of pulmonary tuberculosis in children”

BMC Infectious Diseases

Jose T Ramos Amador¹  Beatriz Soto Sánchez¹  Ana Álvarez García¹  Juana B Cacho Calvo²  Luis M Prieto Tato¹  Sara Guillén Martín¹  Marta Ruiz Jiménez¹ 

[1] Department of Pediatrics, Getafe Hospital, Caterreta de Toledo Km 12.5, Madrid 28905, Spain;Department of Microbiology, Getafe Hospital, Carretera de Toledo, Km 12.5, Madrid 28905, Spain

关键词: Diagnosis;    Induced sputum;    Children;    Tuberculosis;   

Others  :  1148393
DOI  :  10.1186/1471-2334-13-222

 received in 2012-08-06, accepted in 2013-05-08,  发布年份 2013

【 摘 要 】

Background

Diagnosis of pulmonary tuberculosis (PTB) is difficult in infants and young children. For microbiological confirmation of PTB children, sequential gastric lavage (GL) is recommended. Induced sputum (IS) may be an alternative or complementary tool, but the information is limited in children in developed countries. The aim of this study is to assess the safety and diagnostic yield from IS combined with GL for PTB diagnosis in non-HIV infected children.

Methods

The study involved 22 children with suspected PTB admitted to the Getafe Hospital from January 2007 to May 2011. IS and GL were performed on three consecutive days, according to a standardized protocol. In all samples, BK staining, culture and PCR were carried out, including Genotype MTBDR plus for resistance to INH-RIF (Isoniazid-Rifampin) since 2008. A preliminary analysis of an ongoing prospective study is presented.

Results

Median age was 72 months (range 1 month to 14 years of age). Seven (33%) were ≤ 5 years of age. Seventeen were clinically diagnosed of PTB based on positive PPD and radiological criteria. Microbiological confirmation was achieved in 10 (58.8%) by either GL or IS. M. tuberculosis was identified by GL in 8 children (47.1%) and by IS in 7 (41.2%). One infant (2 IS samples) had transient oxygen desaturation recovered spontaneously.

Conclusions

IS appears to be safe and well tolerated by children for diagnosis of PTB and is more convenient. Increasing the diagnostic yield of PTB in children with PTB may be a complementary technique. Largest studies are necessary to define the role of IS in paediatric PTB.

【 授权许可】

   
2013 Ruiz Jiménez et al.; licensee BioMed Central Ltd.

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