Feasibility and utility of a combined nasogastric-tube-and-string-test device for bacteriologic confirmation of pulmonary tuberculosis in young children

被引:0
|
作者
Khambati, Nisreen [1 ]
Song, Rinn [1 ,2 ,3 ]
Smith, Jonathan P. [4 ,5 ]
Bijker, Else Margreet [1 ,6 ]
Mccarthy, Kimberly [4 ]
Click, Eleanor S. [4 ]
Mchembere, Walter [7 ]
Okumu, Albert [7 ]
Musau, Susan [7 ]
Okeyo, Elisha [7 ]
Perez-Velez, Carlos M. [8 ]
Cain, Kevin [4 ]
机构
[1] Univ Oxford, Dept Paediat, Oxford Vaccine Grp, Oxford, England
[2] Boston Childrens Hosp, Div Infect Dis, Boston, MA USA
[3] Harvard Med Sch, Dept Pediat, Boston, MA USA
[4] Ctr Dis Control & Prevent, Div Global HIV & TB, Atlanta, GA USA
[5] Yale Sch Publ Hlth, Dept Hlth Policy & Management, New Haven, CT USA
[6] Maastricht Univ, MosaKids Childrens Hosp, Dept Pediat, Med Ctr, Maastricht, Netherlands
[7] Kenya Govt Med Res Ctr, Ctr Global Hlth Res, Kisumu, Kenya
[8] Univ Arizona, Coll Med, Tucson, AZ USA
基金
美国国家卫生研究院;
关键词
Diagnosis; Gastric aspirate; Microbiological confirmation; Pediatric tuberculosis; String; MYCOBACTERIUM-TUBERCULOSIS; XPERT MTB/RIF; DIAGNOSIS; RESISTANCE; TOOL;
D O I
10.1016/j.diagmicrobio.2024.116302
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
For microbiological confirmation of pediatric pulmonary tuberculosis (PTB), gastric aspirates (GA) are often operationally unfeasible without hospitalization, and the encapsulated orogastric string test is not easily swallowed in young children. The Combined-NasoGastric-Tube-and-String-Test (CNGTST) enables dual collection of GA and string specimens. In a prospective cohort study in Kenya, we examined its feasibility in children under five with presumptive PTB and compared the bacteriological yield of string to GA. Paired GA and string samples were successfully collected in 95.6 % (281/294) of children. Mycobacterium tuberculosis was isolated from 7.0 % (38/541) of GA and 4.3 % (23/541) of string samples, diagnosing 8.2 % (23/281) of children using GA and 5.3 % (15/281) using string. The CNGTST was feasible in nearly all children. Yield from string was two-thirds that of GA despite a half-hour median dwelling time. In settings where the feasibility of hospitalisation for GA is uncertain, the string component can be used to confirm PTB.
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页数:7
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