RNTCP（NTEP）指南在儿科结核病微生物学确诊中的应用。

Utility of RNTCP (NTEP) guidelines in microbiological confirmation of pediatric tuberculosis.

机构信息

Department of Pediatrics, St John's Medical College Hospital, Bengaluru, Karnataka, India.

出版信息

Indian J Tuberc. 2022 Apr;69(2):161-165. doi: 10.1016/j.ijtb.2021.06.007. Epub 2021 Jun 15.

DOI:10.1016/j.ijtb.2021.06.007

PMID:35379396

Abstract

OBJECTIVE

To estimate the proportion of microbiologically confirmed disease among children diagnosed with tuberculosis using RNTCP guidelines.

MATERIALS AND METHODS

Retrospective chart review of a cohort of 151 children (aged between 1 month and 18 years) diagnosed with Tuberculosis between December 2016 and June 2020 at a pediatric department of a tertiary care hospital. We collected information on AFB (Acid Fast Bacillus) smear and Cartridge Based Nucleic Acid Amplification Test (CB NAAT) results.

RESULTS

Out of 151 children with a diagnosis of Tuberculosis, 66 (44%) children were found to have microbiologically confirmed disease. Confirmatory rate was almost equal in children less than <5 and >5 years (48% vs 52%). Confirmatory rate did not differ between pulmonary and extra pulmonary samples (49% and 53%). Cartridge Based Nucleic Acid Amplification Test outperformed AFB by 10%, which was statistically significant (p = .000 by fisher exact test).

CONCLUSION

Although considered paucibacillary in nature, microbiological confirmation can be obtained in almost up to half of children with a diagnosis of TB by using RNTCP guidelines. Neither young age nor type of TB is a deterrent to bacteriologically confirm TB in children.

摘要

目的

根据 RNTCP 指南，估计经诊断患有结核病的儿童中经微生物学证实的疾病比例。

材料和方法

对 2016 年 12 月至 2020 年 6 月在一家三级保健医院儿科部门诊断为结核病的 151 名（1 个月至 18 岁之间）儿童的队列进行回顾性图表审查。我们收集了 AFB（抗酸杆菌）涂片和基于试剂盒的核酸扩增检测（CB NAAT）结果的信息。

结果

在 151 名诊断为结核病的儿童中，有 66 名（44%）儿童被发现患有经微生物学证实的疾病。<5 岁和>5 岁的儿童的确诊率几乎相等（48%比 52%）。肺外和肺内样本的确诊率没有差异（分别为 49%和 53%）。试剂盒核酸扩增检测比 AFB 高出 10%，具有统计学意义（Fisher 确切检验，p=0.000）。