Rapid molecular diagnosis of pulmonary tuberculosis in children using nasopharyngeal specimens
Rapid diagnosis of paediatric pulmonary TB (PTB) using Xpert on induced sputum (IS) is possible but capacity for performing IS is limited. Diagnosis on a nasopharyngeal aspirate (NPA), which can be non-invasively obtained, is desirable.
Methods. Paired specimens (NPA and IS) were investigated using smear, liquid culture and Xpert. Diagnostic accuracy of Xpert and smear was compared with culture for different specimens in children with suspected PTB.
Results. 535 children [median age 19 months, 117 (21·9%) HIV-infected] had one IS and NPA; 396 had two paired specimens. A positive smear, Xpert or culture occurred in 30 (5.6%), 81 (15.1%) and 87 (16.3%) respectively. Culture yield was higher from IS (84/87, 96.6%) vs NPA (61/87, 70.1%, p
Conclusion. Xpert on 2 NPAs is useful in children with suspected PTB particularly in settings where IS and culture are not feasible.
Zar, H.J.; Workman, L.; Isaacs, W.; Munro, J.; Black, F.; Eley, B.; Allen, V.; Boehme, C.C.; Zemanay, W.; Nicol, M.P. Rapid molecular diagnosis of pulmonary tuberculosis in children using nasopharyngeal specimens. Clinical Infectious Diseases (2012) : [DOI: 10.1093/cid/cis598]