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Rapid molecular diagnosis of pulmonary tuberculosis in children using nasopharyngeal specimens
Authors:Zar Heather J  Workman Lesley  Isaacs Washiefa  Munro Jacinta  Black Faye  Eley Brian  Allen Veronica  Boehme Catharina C  Zemanay Widaad  Nicol Mark P
Affiliation:Department of Paediatrics and Child Health, University of Cape Town.
Abstract:
Background.?A rapid diagnosis of pediatric pulmonary tuberculosis (PTB) using Xpert MTB/RIF (Mycobacterium tuberculosis/rifampicin) automated testing on induced sputum (IS) is possible, but the capacity for performing IS is limited. The diagnosis using a nasopharyngeal aspirate (NPA), which can be non-invasively obtained, is desirable. Methods.?Paired specimens (NPA and IS) were tested using smear, liquid culture and Xpert. The diagnostic accuracy of Xpert and smear was compared with culture for different specimens in children with suspected PTB. Results.?There were 535 children [median age 19 months, 117 (21·9%) HIV-infected] who had one IS and one NPA specimen; 396 had two paired specimens. A positive smear, Xpert test or culture occurred in 30 (5.6%), 81 (15.1%) and 87 children (16.3%), respectively. The culture yield was higher from IS (84/87, 96.6%) vs NPA (61/87, 70.1%, P?
Keywords:
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