Çakır Erkan, Özdemir Ali, Daşkaya Hayrettin, Umutoğlu Tarık, Yüksel Mine
Departments of Pediatric Pulmonology, Bezmialem Vakif University, Istanbul, Turkey.
Departments of Pediatric Pulmonology, Mersin City Hospital, Mersin, Turkey.
Turk J Pediatr. 2018;60(1):10-13. doi: 10.24953/turkjped.2018.01.002.
Çakır E, Özdemir A, Daşkaya H, Umutoğlu T, Yüksel M. The value of nasopharyngeal aspirate, gastric aspirate and bronchoalveolar lavage fluid in the diagnosis of childhood tuberculosis. Turk J Pediatr 2018; 60: 10-13. Pulmonary tuberculosis (TB) is an important cause of morbidity and mortality especially in developing countries. A definitive microbiologic confirmation of Mycobacterium tuberculosis is important in the diagnosis of childhood TB. We aimed to compare the diagnostic value of nasopharyngeal aspirate (NPA), gastric aspirate (GA) and bronchoalveolar lavage (BAL) specimens in children with highly suspected pulmonary tuberculosis (TB). NPA, GA and BAL samples were obtained from forty patients. The mean age was 9.2±4.7 years. Sixty-eight percent of children had a history of household contact and 82% had tuberculin skin test positivity. Acid-fast bacilli (AFB) stain was positive in 22.5% (N=9) of BAL, 17.5% (N=7) of GA, and 10% (N=4) of NPA samples. Positive Lowenstein-Jensen culture was 27.5% (N=11) in BAL, 22.5% (N=9) in GA, and 12.5% (N=5) in NPA samples. Positive AFB stains and growth in TB cultures from BAL fluid and GA samples were both higher than NPA samples (p < 0.006 and p < 0.004, respectively GA). We conclude that NPA specimen fails to determine Mycobacterium tuberculosis in children with highly suspected pulmonary TB when compared to GA or BAL fluid.
恰基尔E、奥兹德米尔A、达什卡亚H、乌穆托格鲁T、于克塞尔M。鼻咽抽吸物、胃抽吸物和支气管肺泡灌洗在儿童结核病诊断中的价值。《土耳其儿科学杂志》2018年；60：10 - 13。肺结核是发病和死亡的重要原因，尤其在发展中国家。结核分枝杆菌的明确微生物学确诊对儿童结核病的诊断很重要。我们旨在比较鼻咽抽吸物（NPA）、胃抽吸物（GA）和支气管肺泡灌洗（BAL）标本对高度疑似肺结核儿童的诊断价值。从40例患者获取了NPA、GA和BAL样本。平均年龄为9.2±4.7岁。68%的儿童有家庭接触史，82%结核菌素皮肤试验呈阳性。抗酸杆菌（AFB）染色在22.5%（N = 9）的BAL样本、17.5%（N = 7）的GA样本和10%（N = 4）的NPA样本中呈阳性。罗氏培养基培养阳性率在BAL样本中为27.5%（N = 11），在GA样本中为22.5%（N = 9），在NPA样本中为12.5%（N = 5）。BAL液和GA样本的AFB染色阳性及结核菌培养生长均高于NPA样本（分别为p < 0.006和p < 0.004，GA）。我们得出结论，与GA或BAL液相比，NPA标本无法确定高度疑似肺结核儿童的结核分枝杆菌。
