[Pediatric tuberculosis at a reference hospital during the 2004-2008 period]

Samples of pediatric patients suspected of tuberculosis and cared for at Hospital Piñero during the 2004-2008 period were analyzed according to epidemiological and clinical criteria. The bacteriological contribution was evaluated to confirm the disease diagnosis. A descriptive retrospective analysis of the cases was done. A total of 8409 samples were received for mycobacterial culture: 1542 (18%) of which were pediatric and distributed as follows: 1407 (91%), pulmonary and 135 (9%), extra-pulmonary. The sample examination included staining for acid-fast bacilli, culture, identification and drug susceptibility testing. The following are the results of analized demographic variables: Nationality: 1218 Argentinean (79%), 247 foreigners (16%) and 77, not disclosed (5%); Gender: 787 female (51%) and 755 male (49%). Patients were grouped according to age into: Group A, 0 to 4 years 674 (45%); Group B, 5-9 years 354 (24%) and Group C, 10-15 years 464 (31%). Morbidity causes associated with the disease were mainly malnutrition and infection by Human Immunodeficiency Virus. Staining for acid-fast bacilli was positive in 41 samples (2.6%) and 84 cultures resulted positive (5.4%), 78 (93%) of which were pulmonary and 6 (7%) extra-pulmonary samples. All the strains were identified as Mycobacterium tuberculosis. Isolates were susceptible to streptomycin, isoniazid, rifampicin, and ethambutol, except for one strain that was resistant both to ethambutol and streptomycin, and another one which was resistant to isoniazid. Bacteriological confirmation of pediatric tuberculosisis is rarely achieved due to the predominantly paucibacillary nature of the disease in children (5% in our study), but plays a fundamental role in diagnosis accuracy, allowing the identification and susceptibility testing of the strain.