Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi, India.
Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, Bahadur Shah Zafar Marg, New Delhi, India.
Indian J Tuberc. 2022 Apr;69(2):178-183. doi: 10.1016/j.ijtb.2021.07.005. Epub 2021 Jul 12.
India houses 27% of the tuberculosis cases worldwide. Pediatric tuberculosis accounts for 11% cases worldwide. Microbiological confirmation of diagnosis is difficult in children. We aimed to study the proportion of Stool CBNAAT (Cartridge Based Nucleic Acid Amplification Test) and GA CBNAAT positive cases among the presumptive cases of tuberculosis in children and assess diagnostic utility of the Stool CBNAAT in comparison to GA CBNAAT and culture.
Ours was a cross sectional study. 75 children, aged 6 months to 12 years who were presumptive cases of pulmonary tuberculosis and who were unable to expectorate, were enrolled. Gastric aspirate and stool samples were obtained and CBNAAT and culture was done. Results of stool CBNAAT were compared with GA CBNAAT and culture.
Of the 75 children enrolled, 28 were started on antitubercular therapy, 12 of whom were microbiologically confirmed and 16 were started on clinical grounds. Overall, 10 (13.3%) and 11 (14.6%) were positive by Stool CBNAAT and GA CBNAAT respectively. GA CBNAAT and Stool CBNAAT were found to have near perfect agreement (Cohen's kappa 0.834). Stool CBNAAT had sensitivity and specificity of 73% and 97% as compared to culture.
Stool CBNAAT may be used for bacteriological confirmation of pediatric pulmonary tuberculosis. It was found to have a high degree of concordance with the conventionally used GA CBNAAT. This test would be helpful in endemic countries where there is a dearth of trained staff, especially in the periphery, to obtain gastric aspirate. Discomfort associated with sampling would be avoided.
印度拥有全球 27%的结核病病例。儿科结核病占全球病例的 11%。儿童的诊断微生物学确认较为困难。我们旨在研究粪便 CBNAAT（基于盒式的核酸扩增测试）和 GA CBNAAT 在疑似结核病儿童病例中的阳性比例，并评估粪便 CBNAAT 与 GA CBNAAT 和培养相比的诊断效用。
这是一项横断面研究。纳入了 75 名年龄在 6 个月至 12 岁之间、无法咳痰的疑似肺结核的儿童。采集胃抽吸物和粪便样本，并进行 CBNAAT 和培养。将粪便 CBNAAT 的结果与 GA CBNAAT 和培养进行比较。
在纳入的 75 名儿童中，28 名开始抗结核治疗，其中 12 名经微生物学确认，16 名根据临床诊断开始治疗。总的来说，粪便 CBNAAT 和 GA CBNAAT 分别有 10 例（13.3%）和 11 例（14.6%）阳性。GA CBNAAT 和粪便 CBNAAT 具有近乎完美的一致性（Cohen 的 kappa 值为 0.834）。粪便 CBNAAT 的敏感性和特异性分别为 73%和 97%，与培养相比。
粪便 CBNAAT 可用于儿童肺结核的细菌学确认。它与常规使用的 GA CBNAAT 具有高度一致性。在缺乏训练有素的人员的流行国家，特别是在周边地区，该检测有助于获得胃抽吸物。可以避免采样相关的不适。
