1921
Volume 79, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Pediatric pulmonary tuberculosis diagnosis is difficult because young children are unable to expectorate sputum samples. Testing stool for tuberculosis DNA from swallowed sputum may diagnose pulmonary tuberculosis. Hospitalized children with suspected tuberculosis had stool, nasopharyngeal, and gastric aspirates cultured that confirmed pulmonary tuberculosis in 16/236 patients. Twenty-eight stored stools from these 16 children were used to evaluate stool polymerase chain reaction (PCR) for tuberculosis diagnosis compared with 28 stool samples from 23 healthy control children. Two DNA extraction techniques were used: fast-DNA mechanical homogenization and Chelex-resin chemical extraction. DNA was tested for tuberculosis DNA with a hemi-nested IS6110 PCR. PCR after Fast-DNA processing was positive for 6/16 culture-proven tuberculosis patients versus 5/16 after Chelex extraction (sensitivity 38% and 31%, respectively). All controls were negative (specificity 100%). If sensitivity can be increased, stool PCR would be a rapid, non-invasive, and relatively bio-secure initial test for children with suspected pulmonary tuberculosis.

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2008-12-01
2017-09-22
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References

  1. WHO–WHO/TUB, 2003. Guidelines for Tuberculosis Treatment in Adults and Children in National Tuberculosis Programs. Tuberculosis Unit Division of Communicable Diseases. Third edition. Geneva: World Health Organization.
  2. WHO, 1995. Tuberculosis. Fact sheet No. 93. Geneva: World Health Organization.
  3. Khan EA, Starke JR, 1995. Diagnosing tuberculosis in children: increased need for better methods. Emerg Infect Dis 1 : 115–123.
  4. Oberhelman RA, Soto-Castellares G, Caviedes L, Castillo ME, Kissinger P, Moore DA, Evans C, Gilman RH, 2006. Improved recovery of Mycobacterium tuberculosis from children using the microscopic observation drug susceptibility method. Pediatrics 118 : e100–e106.
  5. Zar HJ, Hanslo D, Apolles P, Swingler G, Hussey G, 2005. Induced sputum versus gastric lavage for microbiological confirmation of pulmonary tuberculosis in infants and young children: a prospective study. Lancet 365 : 130–134.
  6. Schoch OD, Rieder P, Tueller C, Altpeter E, Zellweger JP, Rieder HL, Krause M, Thurnheer R, 2007. Diagnostic yield of sputum, induced sputum, and bronchoscopy after radiologic tuberculosis screening. Am J Respir Crit Care Med 175 : 80–86.
  7. Getchell WS, Davis CE, Gilman J, Urueta G, Ruiz-Huidrobo E, Gilman RH, 1992. Basic epidemiology of tuberculosis in Peru: a prevalence study of tuberculin sensitivity in a pueblo joven. Am J Trop Med Hyg 47 : 721–729.
  8. Sanghavi DM, Gilman RH, Lescano-Guevara AG, Checkley W, Cabrerea L, Cardenas V, 1998. Hyperendemic pulmonary tuberculosis in a Peruvian shantytown. Am J Epidemiol 148 : 384–389.
  9. Ampofo KK, Saiman L, 2002. Pediatric tuberculosis. Pediatr Ann 31 : 98–108.
  10. Smith KC, Starke JR, Eisenach K, Ong LT, Denby M, 1996. Detection of Mycobacterium tuberculosis in clinical specimens from children using a polymerase chain reaction. An Pediatr (Barc) 97 : 155–160.
  11. Montenegro SH, Gilman RH, Sheen P, Cama R, Caviedes L, Hopper T, Chambers R, Oberhelman RA, 2003. Improved detection of Mycobacterium tuberculosis in Peruvian children by use of a heminested IS6110 polymerase chain reaction assay. Clin Infect Dis 36 : 16–23.
  12. Neu N, Saiman L, San Gabriel P, Whittier S, Knirsch C, Ruzal-Shapiro C, Della-Latta P, 1999. Diagnosis of pediatric tuberculosis in the modern era. Pediatr Infect Dis 18 : 122–126.
  13. Dalovisio JR, Montenegro-James S, Kemmerly SA, Genre CF, Chambers R, Greer D, Pankey GA, Failla DM, Haydel KG, Hutchinson L, Lindley MF, Nunez BM, Praba A, Eisenach KD, Cooper ES, 1996. Comparison of the amplified Mycobacterium tuberculosis (MTB) direct test, Amplicor MTB PCR, and IS6110-PCR for detection of MTB in respiratory specimens. Clin Infect Dis 23 : 1099–1106.
  14. Delacourt C, Poveda JD, Chureau C, Beydon N, Mahut B, de Blic J, Scheinmann P, Garrigue G, 1995. Use of polymerase chain reaction for improved diagnosis of tuberculosis in children. J Pediatr 126 : 703–709.
  15. Stegen G, Jones K, Kaplan P, 1969. Criteria for guidance in the diagnosis of tuberculosis. Pediatrics 43 : 260–263.
  16. Franchi LM, Cama RI, Gilman RH, Montenegro-James S, Sheen P, 1998. Detection of Mycobacterium tuberculosis in nasopharyngeal aspirate samples in children. Lancet 352 : 1681–1682.
  17. Kent BD, Kubica GP, 1985. Public Health Mycobacteriology: A Guide for the Level III Laboratory. Atlanta: US Dept. Health and Human Services, Centers for Disease Control, 36–39, 47–69, 185–187.
  18. Caviedes L, Lee TS, Gilman RH, Sheen P, Spellman E, Lee EH, Berg DE, Montenegro-James S, 2000. Rapid, efficient detection and drug susceptibility testing of Mycobacterium tuberculosis in sputum by microscopic observation of broth cultures. J Clin Microbiol 38 : 1203–1208.
  19. Moore DA, Evans CA, Gilman RH, Caviedes L, Coronel J, Vivar A, Sanchez E, Piñedo Y, Saravia JC, Salazar C, Oberhelman R, Hollm-Delgado MG, LaChira D, Escombe AR, Friedland JS, 2006. Microscopic-observation drug-susceptibility assay for the diagnosis of TB. N Engl J Med 355 : 1539–1550.
  20. Getchell WS, Davis CE, Gilman J, Urueta G, Ruiz-Huidobro E, Gilman RH, 1992. Basic epidemiology of tuberculosis in Peru: a prevalence study of tuberculin sensitivity in a pueblo joven. Am J Trop Med Hyg 47 : 721–729.
  21. Salazar GE, Schmitz TL, Cama R, Sheen P, Franchi LM, Centeno G, Valera C, Leyva M, Montenegro-James S, Oberhelman R, Gilman RH, Thompson MJ, Working Group on TB in Peru, 2001. Pulmonary tuberculosis in children in a developing country. Pediatrics 108 : 448–453.
  22. Escalante P, Ramaswamy S, Sanabria H, Soini H, Pan X, Valiente-Castillo O, Musser JM, 1998. Genotypic characterization of drug-resistant Mycobacterium tuberculosis isolates from Peru. Tubercle Lung Dis 79 : 111–118.
  23. Williams DL, Spring L, Gillis TP, Salfinger M, Persing DH, 1998. Evaluation of a polymerase chain reaction-based universal heteroduplex generator assay for direct detection of rifampin susceptibility of Mycobacterium tuberculosis from sputum specimens. Clin Infect Dis 26 : 446–450.
  24. Leung AN, Muller NL, Pineda PR, FitzGerald JM, 1992. Primary tuberculosis in childhood: radiographic manifestations. Radiology 182 : 87–91.
  25. American Thoracic Society, 2000. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med 161 : 1376–1395.
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  • Received : 13 Nov 2007
  • Accepted : 29 Jul 2008

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