Preliminary Results Of A Comparative Yield Study Of Induced Sputum, String Test, And Gastric Aspirate For The Microbiological Diagnosis Of Pulmonary Tuberculosis In Children

Pérez-Vélez, Carlos M.; Wilches-Luna, Esther Cecilia; Hernández-Sarmiento, José Mauricio; Casanova-Reynolds, Addis L.; Hernández, Nelly; Moreno-Ortega, Sandra P.; Atehortúa-Muñoz, Santiago; Rozo-Anaya, Juan C.; Mejía, Gloria Isabel; Gomez, Verónica; Ferro, Beatriz E.; Prada-Quiroz, Ana E.; Moreira, César Augusto; Duque-Loaiza, William; Martínez, Milton; Daley, Charles L.; Robledo, Jaime

doi:10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a1775

Cited by 3 publications

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“…Table 6 provides an overview of specimen collection techniques (Marais and Pai 2006). The string test works well in sputumscarce adults and preliminary results in children seem promising (Perez-Velez et al 2010), although administration is difficult in young children who are unable to swallow the string-containing capsule. With adequate DNA extraction protocols, stool also offers promise as a diagnostic specimen (Nicol et al 2013).…”

Section: Tuberculosis In Childrenmentioning

confidence: 99%

Tuberculosis in Children

Marais

Schaaf

2014

Cold Spring Harbor Perspectives in Medicine

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Section: Tuberculosis In Childrenmentioning

confidence: 99%

Tuberculosis in Children

Marais

Schaaf

2014

Cold Spring Harbor Perspectives in Medicine

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“…13 For this reason, several studies tried to identify the most efficient and safest technique to collect respiratory samples from children that allow the isolation of the mycobacterium by culture; however, the results so far have been diverse. 11 The first comparative study was published in 2000 by Zar et al 14 who found that IS was the technique with the highest performance compared with gastric juice (p ¼ 0.08). However, in this research, the patients studied had a low pretest probability for pulmonary TB, the procedure of collection of the gastric juice was variable among the patients, while the IS technique was standardized and the research staff was trained to perform it.…”

Section: Discussionmentioning

confidence: 99%

“…The studies, to date, show great variability in the results due to the differences in the sample size, risk of TB of the population studied (pretest probability), inclusion criteria, sample collection protocol, and processing thereof. 9,10 The pediatric service of San Vicente Foundation University Hospital participated in the study where three types of techniques for sampling IS, GA, and the string test for confirmation of TB in children were evaluated 11 ; after this participation in the research, the diagnosis protocol of childhood TB was modified in 2011 and the collection of two samples of IS and two samples of GA was implemented, unlike the previous years in which only three GA samples were taken on consecutive days. However, the impact of this measure on microbiological confirmation has not been evaluated to date, which motivated this research.…”

Section: Introductionmentioning

confidence: 99%

Combined Use of Gastric Aspirate and Induced Sputum Increases the Microbiological Diagnosis of Tuberculosis in Children

Atehortúa-Muñoz

Cardona-Moreno

Niño-Quiroga

et al. 2020

Journal of Pediatric Infectious Diseases

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Introduction Diagnosis of pulmonary tuberculosis (PTB) in pediatrics is a challenge due to the paucibacillary condition of the disease in this population, low sputum expectoration, and diverse unspecific symptomatology. Mycobacterial isolation through culture remains a priority. The objective of this study is to explore gastric aspirates and induced sputum techniques in the pediatric population for positivity on mycobacterial cultures. Methods In this observational analytical study, two temporal groups were evaluated. A comparison of the isolation rate defined as positive culture confirmation by gastric aspirate (GA), induced sputum (IS), or combination of these both techniques in children under 10 years of age. The study included 86 children, 37 in the first evaluated study group and 49 in the second group. Discussion Culture positivity was 10.8 and 30.6% for the first and second case series, respectively. These findings showed that the combination of GA and IS in two consecutive days yielded a significantly higher detection rate to confirm pulmonary tuberculosis by culture. Conclusion The combination of GA plus IS samples for collection of M. tuberculosis culture can be a useful, nonexpensive, and safe diagnostic tool in low- and middleincome countries to diagnose tuberculosis in children.

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“…In cooperative children (aged >4 years) able to swallow the gelatin capsule containing the string, the conventional string test is associated with minimal discomfort. In younger children unable to swallow the capsule, the combined nasogastric-tube-and-string test allows two specimens (one gastric aspirate and one string test) to be collected [54, 55]. As young children swallow their sputum, stool may also contain M. tuberculosis and a nucleic acid amplification test (NAAT), such as Xpert MTB/RIF (Cepheid, United States of America), on stool can bacteriologically confirm approximately 45% of clinically diagnosed cases of pulmonary TB [56, 57].…”

Section: Step 2: Identify Findings Supportive Of Tb As the Etiologymentioning

confidence: 99%

Tuberculosis exposure, infection and disease in children: a systematic diagnostic approach

Roya-Pabón

Pérez-Vélez

2016

Pneumonia

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The accurate diagnosis of tuberculosis (TB) in children remains challenging. A myriad of common childhood diseases can present with similar symptoms and signs, and differentiating between exposure and infection, as well as infection and disease can be problematic. The paucibacillary nature of childhood TB complicates bacteriological confirmation and specimen collection is difficult. In most instances intrathoracic TB remains a clinical diagnosis. TB infection and disease represent a dynamic continuum from TB exposure with/without infection, to subclinical/incipient disease, to non-severe and severe disease. The clinical spectrum of intrathoracic TB in children is broad, and the classification of clinical, radiological, endoscopic, and laboratory findings into recognized clinical syndromes allows a more refined diagnostic approach in order to minimize both under- and over-diagnosis. Bacteriological confirmation can be improved significantly by collecting multiple, high-quality specimens from the most appropriate source. Mycobacterial testing should include traditional smear microscopy and culture, as well as nucleic acid amplification testing. A systematic approach to the child with recent exposure to TB, or with clinical and radiological findings compatible with this diagnosis, should allow pragmatic classification as TB exposure, infection, or disease to facilitate timely and appropriate management. It is important to also assess risk factors for TB disease progression and to undertake follow-up evaluations to monitor treatment response and ongoing evidence supporting a TB, or alternative, diagnosis.Electronic supplementary materialThe online version of this article (doi:10.1186/s41479-016-0023-9) contains supplementary material, which is available to authorized users.

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Preliminary Results Of A Comparative Yield Study Of Induced Sputum, String Test, And Gastric Aspirate For The Microbiological Diagnosis Of Pulmonary Tuberculosis In Children

Cited by 3 publications

References 0 publications

Tuberculosis in Children

Tuberculosis in Children

Combined Use of Gastric Aspirate and Induced Sputum Increases the Microbiological Diagnosis of Tuberculosis in Children

Tuberculosis exposure, infection and disease in children: a systematic diagnostic approach

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