Laboratoire des Mycobactéries, Institut Pasteur de Bangui, Bangui, Central African Republic, CAR.
BMC Pediatr. 2012 Dec 13;12:191. doi: 10.1186/1471-2431-12-191.
Tuberculosis (TB) is a major cause of childhood morbidity and mortality in developing countries. One of the main difficulties is obtaining adequate specimens for bacteriological confirmation of the disease in children.The aim of this study is to evaluate the adequacy of fine-needle aspiration (FNA) for the diagnosis of TB.
In a prospective study conducted at the paediatric hospital in Bangui in 2007-2009, we used fine-needle aspiration to obtain samples for diagnosis of TB from 131 children aged 0-17 years with persistent lymphadenitis.
Fine-needle aspiration provided samples that could be used for bacteriological confirmation of TB. Ziehl-Neelsen staining for acid-fast bacilli was positive in 42.7% of samples, and culture identified TB in 67.2% of cases. Of 75 samples that were stain-negative, 49 (65.3%) were culture-positive, while 12 stain-positive samples remained culture-negative. Ten of the 12 stain-positive, culture-negative samples were from patients who had received previous antimicrobial therapy. With regard to phenotypic drug susceptibility, 81/88 strains (91.1%) were fully susceptible to isoniazid, rifampicin, ethambutol and streptomycin, six (6.8%) were resistant to one drug, and one multidrug-resistant strain was found.
Fine-needle aspiration is simple, cost-effective and non-invasive and can be performed by trained staff. Combined with rapid molecular diagnostic tests, fine-needle aspirates could improve the diagnosis of TB and provide valuable information for appropriate treatment and drug resistance.
结核病（TB）是发展中国家儿童发病和死亡的主要原因之一。主要困难之一是为儿童获得足够的标本进行细菌学确诊。本研究旨在评估细针抽吸（FNA）在结核病诊断中的充分性。
在 2007-2009 年在班吉儿科医院进行的一项前瞻性研究中，我们使用细针抽吸从 131 名年龄在 0-17 岁的持续淋巴结炎的儿童中获得用于诊断结核病的样本。
细针抽吸提供了可用于细菌学确认结核病的样本。42.7%的样本中抗酸杆菌的齐-尼染色阳性，67.2%的病例培养确定了结核病。在 75 份染色阴性的样本中，49 份（65.3%）培养阳性，而 12 份染色阳性的样本仍培养阴性。在 12 份染色阳性、培养阴性的样本中，有 10 份来自曾接受过抗菌治疗的患者。关于表型药物敏感性，88 株中的 81 株（91.1%）对异烟肼、利福平、乙胺丁醇和链霉素完全敏感，6 株（6.8%）对一种药物耐药，发现一株耐多药菌株。
细针抽吸简单、具有成本效益且无创伤，可由经过培训的工作人员进行。与快速分子诊断测试相结合，细针抽吸可提高结核病的诊断，并为适当的治疗和耐药性提供有价值的信息。
