Related Experiment Video
Updated: Aug 26, 2025
Analysis of 18FDG PET/CT Imaging as a Tool for Studying Mycobacterium tuberculosis Infection and Treatment in Non-human Primates
Published on: September 5, 2017
Bacteremia tuberculosis among HIV-negative children in China
Ping Chu1,2, Jin Shi3, Fang Dong4
1Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute Beijing Children's Hospital, Capital Medical University, National Center for Children's Health Beijing China.
Insights
Pediatric bacteremia tuberculosis (TB) is rare, with Bacillus Calmette-Guérin (BCG) bacteremia occurring in younger, immunocompromised children. Early diagnosis and intervention are crucial for better outcomes in these severe TB cases.
Area of Science:
- Pediatric Infectious Diseases
- Mycobacterial Infections
- Immunology
Background:
- Bacteremia tuberculosis (TB) is a severe extrapulmonary form of TB, with limited data on pediatric cases, particularly in HIV-negative children.
- Understanding the clinical spectrum of TB bacteremia in children is essential for timely diagnosis and management.
Purpose of the Study:
- To investigate the clinical characteristics of pediatric patients diagnosed with bacteremia tuberculosis.
- To differentiate clinical features between Mycobacterium tuberculosis bacteremia and Bacillus Calmette-Guérin (BCG) bacteremia in children.
Main Methods:
- Retrospective review of clinical records and blood culture isolates from pediatric patients.
- Genotyping of bacterial strains using mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR).
- Drug susceptibility testing using alamarBlue assay and identification of drug-resistant mutations via PCR and DNA sequencing.
Main Results:
- 13 pediatric bacteremia TB cases were identified, 10 with BCG bacteremia. BCG bacteremia was more prevalent in younger children and associated with primary immunodeficiency diseases and lower CD4, IgA, and IgE levels.
- Fever and respiratory symptoms were common in all patients. Adverse post-BCG vaccination reactions were noted in nearly half of the patients.
- Mycobacterium tuberculosis bacteremia patients had different clinical presentations compared to BCG bacteremia.
Conclusions:
- Bacteremia TB, especially BCG-related, can be rapidly fatal in immunocompromised children, necessitating high clinical suspicion.
- Diagnostic specificity is challenging; further research is needed for rapid diagnostic tests and empirical therapy guidelines in childhood bacteremia TB.
Importance:
Bacteremia tuberculosis (TB) is a severe form of extrapulmonary TB. Studies assessing bacteremia TB in children are limited, especially for HIV-negative children.
Objective:
To explore the detailed clinical features of the bacteremia TB in children under 18 years of age.
Methods:
We reviewed the clinical records of the patients retrospectively and collected the strains isolated from their blood cultures. We used mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) to characterize the bacterial genotypes and alamarBlue to determine their drug susceptibility profiles. Polymerase chain reactions and DNA sequencing were used to identify drug-resistant mutations.
Results:
There were 13 pediatric bacteremia TB patients, 10 of whom were diagnosed with Bacillus Calmette-Guérin (BCG) bacteremia TB. Thirteen patients aged from 0.30 to 11.58 years were enrolled, of whom 76.92% were boys. All had fevers before hospitalization, and 76.92% had respiratory symptoms. All had received BCG vaccinations, and 46.15% had adverse post-vaccination reactions. Compared with Mycobacterium tuberculosis, BCG bacteremia was more likely to appear in younger children. Patients with BCG bacteremia had primary immunodeficiency diseases, and lower CD4, IgA, and IgE levels.
Interpretation:
Bacteremia TB was rapidly fatal in a large proportion of the immunodeficient children. Because classic findings may not be diagnostically specific, a high level of clinical suspicion is required, especially for patients with certain types of immunosuppression. Studies are needed to develop rapid diagnostic tests and to determine the value of empirical therapy in childhood bacteremia TB.
Related Concept Videos
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
01:31Pulmonary Tuberculosis III
The first classification is based on the development of the disease, and it includes the following categories:
01:28Pulmonary Tuberculosis II
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...