Xpert MTB/RIF在疑似肺结核儿童支气管肺泡灌洗中的诊断效能
Diagnostic Yield of Xpert MTB/RIF in Bronchoalveolar Lavage in Children with Probable Pulmonary Tuberculosis.
作者信息
Saini Isha, Mukherjee Aparna, Gautam Hitender, Singla Mohit, Jat K R, Lodha Rakesh, Singh Urvashi B, Kabra S K
机构信息
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
出版信息
Indian Pediatr. 2018 Dec 15;55(12):1062-1065.
OBJECTIVE
To evaluate utility of Xpert MTB/RIF in bronchoalveolar lavage fluid in children with probable pulmonary tuberculosis.
METHODS
Children with probable pulmonary tuberculosis with negative smear and Xpert on induced sputum/gastric aspirate were subjected to bronchoalveolar lavage (BAL) for Xpert assay and mycobacterial liquid culture. Data of children <14 y undergoing bronchoscopy for suspected MDR-TB (n=12) were also analyzed. The sensitivity of Xpert in BAL fluid for diagnosis of probable and confirmed pulmonary tuberculosis was calculated with clinico-radiological diagnosis and culture as gold standards, respectively.
RESULTS
Of 41 enrolled children, 24 (58.5%) had Xpert positive in BAL fluid and 11 (26.8%) had culture confirmed tuberculosis (BAL fluid;10; sputum,1). The sensitivity of Xpert in BAL fluid among probable and culture confirmed tuberculosis cases was 58.5% (24/41) and 81.8% (9/11), respectively.
CONCLUSION
Xpert in bronchoalveolar lavage fluid has good sensitivity in both probable and confirmed pulmonary tuberculosis in children.
目的
评估Xpert MTB/RIF在疑似肺结核儿童支气管肺泡灌洗液中的应用价值。
方法
对痰涂片及诱导痰/胃灌洗液Xpert检测阴性的疑似肺结核儿童进行支气管肺泡灌洗（BAL），行Xpert检测及分枝杆菌液体培养。对14岁以下因疑似耐多药结核病接受支气管镜检查的儿童（n = 12）的数据也进行了分析。分别以临床放射学诊断和培养为金标准，计算BAL液中Xpert诊断疑似和确诊肺结核的敏感性。
结果
41例入选儿童中，24例（58.5%）BAL液Xpert检测阳性，11例（26.8%）培养确诊为结核病（BAL液；10例；痰液，1例）。疑似和培养确诊肺结核病例中，BAL液Xpert检测的敏感性分别为58.5%（24/41）和81.8%（9/11）。
结论
支气管肺泡灌洗液中的Xpert在儿童疑似和确诊肺结核中均具有良好的敏感性。
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