Department of Infectious Diseases, Great Ormond Street Hospital, Great Ormond Street, London, United Kingdom.
Pediatr Infect Dis J. 2012 Mar;31(3):302-5. doi: 10.1097/INF.0b013e318249f26d.
Childhood tuberculosis accounts for a significant proportion of the global tuberculosis disease burden. However, tuberculosis in children is difficult to diagnose, because disease tends to be paucibacillary and sputum samples are often not easy to obtain. The diagnosis of tuberculosis in children is traditionally based on chest radiography, tuberculin skin testing, and mycobacterial staining/culture from appropriate samples. Newer diagnostic strategies have included improved bacteriologic and molecular methods, as well as new methods for sample collection from children. Recently, immune-based diagnostics, such as the interferon-gamma release assays, have been introduced for clinical use. These tests do not offer substantial improvements in sensitivity over tuberculin skin testing for the diagnosis of active disease but may be useful in excluding false-positive tuberculin skin tests. Further research is needed to develop better diagnostic tests for tuberculosis in children.
儿童结核病在全球结核病负担中占很大比例。然而，儿童结核病难以诊断，因为疾病往往菌量较少，且通常难以获得痰液样本。儿童结核病的传统诊断方法基于胸部 X 光片、结核菌素皮肤试验和从适当样本中进行分枝杆菌染色/培养。较新的诊断策略包括改进的细菌学和分子方法，以及从儿童收集样本的新方法。最近，免疫诊断方法，如干扰素-γ释放试验，已被引入临床使用。这些测试在诊断活动性疾病方面与结核菌素皮肤试验相比并没有显著提高敏感性，但可能有助于排除结核菌素皮肤试验的假阳性。需要进一步研究来开发更好的儿童结核病诊断测试。
