Rapid detection of Mycobacterium tuberculosis in children using blood and urine specimens.

Autor:	Costa-Lima JFD; Instituto Aggeu Magalhães/Fundação Oswaldo Cruz, Laboratório de Imunoepidemiologia, Departamento de Imunologia, Recife, PE, Brasil.; Universidade Federal do Rio de Janeiro, Programa de Pós-Graduação Stricto Sensu em Clínica Médica, Rio de Janeiro, RJ, Brasil., Pimentel LMLM; Instituto Aggeu Magalhães/Fundação Oswaldo Cruz, Laboratório de Imunoepidemiologia, Departamento de Imunologia, Recife, PE, Brasil., Santos FCF; Instituto Aggeu Magalhães/Fundação Oswaldo Cruz, Laboratório de Imunoepidemiologia, Departamento de Imunologia, Recife, PE, Brasil., Salazar MP; Instituto Aggeu Magalhães/Fundação Oswaldo Cruz, Laboratório de Imunoepidemiologia, Departamento de Imunologia, Recife, PE, Brasil., Duarte RS; Universidade Federal do Rio de Janeiro, Instituto de Microbiologia Paulo Góes, Laboratório de Micobactérias, Rio de Janeiro, RJ, Brasil., Mello FCQ; Universidade Federal do Rio de Janeiro, Instituto de Doenças do Tórax, Faculdade de Medicina, Rio de Janeiro, RJ, Brasil.; Universidade Federal do Rio de Janeiro, Programa de Pós-Graduação Stricto Sensu em Clínica Médica, Rio de Janeiro, RJ, Brasil., Schindler HC; Instituto Aggeu Magalhães/Fundação Oswaldo Cruz, Laboratório de Imunoepidemiologia, Departamento de Imunologia, Recife, PE, Brasil.; Universidade Federal de Pernambuco, Hospital das Clínicas, Departamento Materno Infantil, Recife, PE, Brasil.
Jazyk:	angličtina
Zdroj:	Revista da Sociedade Brasileira de Medicina Tropical [Rev Soc Bras Med Trop] 2020 Sep 25; Vol. 53, pp. e20200051. Date of Electronic Publication: 2020 Sep 25 (Print Publication: 2020).
DOI:	10.1590/0037-8682-0051-2020
Abstrakt:	Introduction: Laboratory and clinical features of childhood tuberculosis (TB) are non-specific and establishing an accurate diagnosis remains a challenge. This study evaluated a Single tube nested-PCR (STNPCR) to detect genomic DNA of Mycobacterium tuberculosis complex in blood and urine. Methods: Biological samples were obtained from children (<15 years old) with clinical suspicion of pulmonary and extrapulmonary TB at public hospitals in Recife-Pernambuco, Brazil. Cultures yielded negative results in a majority of childhood TB cases, which are generally paucibacillary. A set of clinical, epidemiological, radiological, and laboratory criteria with evident clinical improvement after anti-TB treatment were frequently used to define childhood TB cases. Results: Ninety children with clinical suspicion were enrolled in this study (44 with TB and 46 without TB). The pulmonary TB group had 20 confirmed cases and 46 negative controls, while the extrapulmonary TB group had 24 confirmed cases. The STNPCR showed sensitivities to pulmonary and extrapulmonary TB of 47.4% and 52.2% (blood) and 38.8% and 20% (urine), respectively. Considering the low performance of STNPCR on separate samples, we decided to perform a combined analysis (parallel sensitivity analysis) of the results from blood and urine samples. The parallel sensitivity increased to 65% in blood and 62.5% in urine. The specificity in both samples ranged from 93.5-97.8%. Conclusions: Although STNPCR showed moderate sensitivity, the specificity is high; therefore, the test can be used as an auxiliary tool to diagnose TB in children. It is a rapid test that demonstrated better performance than other diagnostic tests in paucibacillary samples as it does in childhood tuberculosis.
Databáze:	MEDLINE
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