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多次胃吸收是否会增加肺结核儿童中M.结核病检测的灵敏度?
Elisabetta Venturini1, Barbara Bortone1, Gianmaria Cini1
1Infectious Diseases Unit, Meyer Children's Hospital IRCCS, Florence, Italy.
European journal of pediatrics
|November 4, 2023
概括
收集三个胃吸附剂 (GA) 显著改善了在儿童中活跃肺结核的微生物确认. 这种方法对年幼的儿童和没有并发症的结核病患者特别有益,增加了诊断灵敏度.
科学领域:
- 儿童传染病 儿童传染病
- 微生物学 微生物学
- 诊断敏感性 诊断敏感性
背景情况:
- 对临床医生来说,诊断儿科结核病 (TB) 存在重大挑战.
- 胃吸入剂 (GA) 是对小儿结核病的微生物学确认的标准,尽管敏感性有限.
- 目前的指导方针建议进行三次顺序的GA,以改善诊断.
研究的目的:
- 评估显微镜,培养和PCR对三个GA的敏感性,以确认儿童的活性肺结核.
- 为了确定收集的GA数量如何影响诊断灵敏度.
- 探索与年龄和放射学模式相关的诊断灵敏度差异.
主要方法:
- 对被诊断患有活跃肺结核的儿童进行了回顾性分析,这些儿童提供了三个GA.
- 来自GA的微生物学数据 (显微镜,培养,PCR) 的评估.
- 测试灵敏度的计算和基于患者年龄和放射学发现的灵敏度变化分析.
主要成果:
- 单个GA的灵敏度为34%;三个GA的累积灵敏度达到47.4%.
- 与第一个GA (p=0.014) 相比,收集三个GA的总体灵敏度增加了13.4%.
- 在4岁以下的儿童和无并发性结核病患者 (p=0.008) 中,敏感性增长显著更高.
结论:
- 执行多次胃吸入可增强儿童活跃肺结核的微生物学确认.
- 增加的GA数量特别有利于在较小的儿童 (≤4岁) 和无复杂放射性模式的儿童中诊断结核病.
- 优化收集的GA数量可以提高儿科结核病的诊断产量.
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