Belén Rocío Imperiale1, Cecilia Nieves2, Belén Mancino2, Myriam Sanjurjo3, Silvina Tártara4, Ángela Beatríz Di Giulio5, Juan Carlos Palomino6, Nora Susana Morcillo2, Anandi Martin7. 1. Institute of Experimental Medicine-CONICET-National Academy of Medicine, Buenos Aires, Argentina. 2. Tuberculosis and Mycobacterioses Laboratory, Dr. Cetrangolo Hospital, Buenos Aires, Argentina. 3. Pediatric Unit, Dr. Cetrangolo Hospital, Buenos Aires, Argentina. 4. Infectious Disease Unit, Dr. Cetrangolo Hospital, Buenos Aires, Argentina. 5. Mycobacteria Laboratory, Cordero Hospital, Buenos Aires, Argentina. 6. Department of Biochemistry and Microbiology, Faculty of Sciences, Ghent University, Ghent, Belgium. 7. Université catholique de Louvain (UCL), Institute of Experimental and Clinical Research, Laboratory of Medical Microbiology, Brussels, Belgium.
Abstract
Background: There is a critical need to improve the diagnostic accuracy of tuberculosis (TB) in children. Several techniques have been developed to improve the quality of sputum samples; however, these procedures are very unpleasant and invasive and require hospitalization and trained personnel. This study aims to explore the potential use of a new and noninvasive tool, "string test," for TB diagnosis in children and in adults not able to render sputum samples and at risk of developing multidrug-resistant TB (MDR-TB). Methods: Children with clinical suspicion of TB attending the pediatric consultation at the Cetrangolo or Cordero Hospitals and adults suspected of MDR-TB and unable to produce sputum attending the Infectious Disease Unit of Cetrangolo Hospital were included in this study. Subjects and Methods: The "string test" is a string that is swallowed by the patients and exposed to gastrointestinal secretions that were late analyzed for TB diagnosis and drug-resistance detection by GenoType MTBDRplus. MedCalc software was used to perform statistical analysis. Results: This technique could be applied on 62.1% of selected children. About 11 (30.6%) children were diagnosed as TB cases, 8 (22.2%) from gastric aspirate and using the "string test." Six out of 19 adults were also diagnosed. Genotype directly on the string specimen detected two MDR-TB in adults and two isoniazid-resistant cases before obtaining the isolate. Conclusion: This test was safe, cheap, and easily implemented without requiring hospitalization. This research could represent a significant step forward to diagnose and rapidly detect drug-resistant TB in children.
Background: There is a critical need to improve the diagnostic accuracy of tuberculosis (TB) in children. Several techniques have been developed to improve the quality of sputum samples; however, these procedures are very unpleasant and invasive and require hospitalization and trained personnel. This study aims to explore the potential use of a new and noninvasive tool, "string test," for TB diagnosis in children and in adults not able to render sputum samples and at risk of developing multidrug-resistant TB (MDR-TB). Methods:Children with clinical suspicion of TB attending the pediatric consultation at the Cetrangolo or Cordero Hospitals and adults suspected of MDR-TB and unable to produce sputum attending the Infectious Disease Unit of Cetrangolo Hospital were included in this study. Subjects and Methods: The "string test" is a string that is swallowed by the patients and exposed to gastrointestinal secretions that were late analyzed for TB diagnosis and drug-resistance detection by GenoType MTBDRplus. MedCalc software was used to perform statistical analysis. Results: This technique could be applied on 62.1% of selected children. About 11 (30.6%) children were diagnosed as TB cases, 8 (22.2%) from gastric aspirate and using the "string test." Six out of 19 adults were also diagnosed. Genotype directly on the string specimen detected two MDR-TB in adults and two isoniazid-resistant cases before obtaining the isolate. Conclusion: This test was safe, cheap, and easily implemented without requiring hospitalization. This research could represent a significant step forward to diagnose and rapidly detect drug-resistant TB in children.
Authors: Karla T Tafur; Julia Coit; Segundo R Leon; Cynthia Pinedo; Silvia S Chiang; Carmen Contreras; Roger Calderon; Milagros J Mendoza; Leonid Lecca; Molly F Franke Journal: BMC Infect Dis Date: 2018-11-15 Impact factor: 3.090