Diagnostic Contribution of Gastric and Bronchial Lavage Examinations in Cases Suggestive of Pulmonary Tuberculosis

Okutan, Oğuzhan; Kartaloğlu, Zafer; Kılıç, Elif; Bozkanat, Erkan; İlvan, Ahmet

doi:10.3349/ymj.2003.44.2.242

Cited by 13 publications

(12 citation statements)

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“…19,[21][22][23][24][25][26] Maciel et al studied variations in procedures in a systematic review and highlighted the need for a standardised protocol for GA in children. 27 Variations observed in the yield of GS in adults are probably also due to non-standardisation of the protocol used for GA and the processing of GS.…”

Section: Discussionmentioning

confidence: 99%

Gastric specimens for diagnosing tuberculosis in adults unable to expectorate in Rawalpindi, Pakistan

Aslam¹,

Tahseen²,

Schomotzer

et al. 2017

public health action

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Section: Discussionmentioning

confidence: 99%

Gastric specimens for diagnosing tuberculosis in adults unable to expectorate in Rawalpindi, Pakistan

Aslam¹,

Tahseen²,

Schomotzer

et al. 2017

public health action

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“…The guardians/parents of each child were instructed to bring the child in the morning after at least a 6-h fast. At least 5 ml of gastric aspirate was collected by the study physician using a nasogastric tube (7). The contents of the stomach were aspirated and placed in a sterile container.…”

Section: Methodsmentioning

confidence: 99%

Does Neutralization of Gastric Aspirates from Children with Suspected Intrathoracic Tuberculosis Affect Mycobacterial Yields on MGIT Culture?

Parashar¹,

Kabra

Lodha

et al. 2013

J Clin Microbiol

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The microbiological confirmation of pulmonary tuberculosis in children relies on cultures of gastric aspirate (GA) specimens. Conventionally, GAs are neutralized to improve culture yields of mycobacteria. However, there are limited data to support this practice. To study the utility of neutralization of GAs with sodium bicarbonate in children with intrathoracic tuberculosis, a total of 116 children of either sex, aged 6 months to 14 years (median age, 120 months; interquartile range [IQR], 7 to 192 months), underwent gastric aspiration on 2 consecutive days. Gastric aspirates were divided into two aliquots, and only one aliquot was neutralized with 1% sodium bicarbonate. Both aliquots were processed for smear and culture examinations. Out of the 232 gastric aspirates, 12 (5.17%) were acid-fast bacilli (AFB) smear positive. There were no differences in smear positivity rates from samples with or without neutralization. The yield of Mycobacterium tuberculosis on a Bactec MGIT 960 culture system was significantly lower in the neutralized samples (16.3% [38/232]) than in the nonneutralized samples (21.5% [50/232]) (P ‫؍‬ 0.023). There was no significant difference between the neutralized and the nonneutralized samples in time to detection using the MGIT 960 system (average, 24.6 days; IQR, 12 to 37 days) (P ‫؍‬ 0.9). The contamination rates were significantly higher in the neutralized samples than in the nonneutralized samples (17.2% [40/232] versus 3.9% [9/232]) (P ‫؍‬ 0.001). The agreement for positive mycobacterial culture between the two approaches was 66.5% (P ‫؍‬ 0.001). Hence, we recommend that gastric aspirate samples not be neutralized with sodium bicarbonate prior to culture for M. tuberculosis. Diagnosis of tuberculosis (TB) in children is based on history, clinical examination, the results of tuberculin skin testing, and imaging. Microbiological confirmation is difficult in children (1) because of the paucibacillary nature of mycobacteria (2, 3). The bacteriological confirmation has relied on the culture of specimens from sequential gastric lavages (4). Gastric aspirates (GAs) are reported to yield smear positivity in no more than 20% of children and positive cultures in less than 50% of children with suspected tuberculosis. Neutralization of gastric aspirates with sodium bicarbonate is conventionally recommended to improve yield on culture (5, 6). To our knowledge, there have been no studies that evaluated the efficacy of neutralization of gastric aspirates with sodium bicarbonate or sodium carbonate. We report here our experience using the liquid Bactec MGIT 960 culture system to perform mycobacterial cultures on gastric aspirates, with and without neutralization with sodium bicarbonate, from children with newly diagnosed intrathoracic tuberculosis. MATERIALS AND METHODSStudy sites and population. This prospective clinical study was conducted in two settings, the All India Institute of Medical Sciences and the Kalawati Saran Children Hospital in New Delhi, India, between January and June 2010. A total ...

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“…A nurse inserts a nasogastric tube into the child's stomach and then aspirates its contents. 11,18,32 The administration of an infusion, time, solution and amount used vary according to different protocols. It can be either an inpatient or outpatient procedure 15 and should be performed in three consecutive days.…”

Section: 23mentioning

confidence: 99%

Coleta de lavado gástrico para diagnóstico de tuberculose pulmonar infantil: revisão sistemática

et al. 2010

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OBJECTIVE:To analyze standardization of gastric lavage protocols in the diagnosis of pulmonary tuberculosis in children. METHODS:A systematic review was conducted for the period between 1968 and 2008 in the following databases: LILACS, SCIELO and MEDLINE. The search strategy included the following terms: "gastric lavage and tuberculosis" or "gastric washing and tuberculosis" with the restriction of "children aged up to 15 years;" "gastric lavage and tuberculosis and childhood" or "gastric washing and tuberculosis and childhood." There were retrieved 80 articles and their analysis was based on information on the gastric lavage protocol for the diagnosis of pulmonary tuberculosis in children: preparation of children and fasting; time of gastric aspiration; aspiration of gastric residues; total volume of aspirate; solution used for aspiration of gastric contents; decontaminant solution; buffer solution; and time for forwarding samples to the laboratory. After a thorough analysis, 14 articles were selected. RESULTS:No article detailed the whole procedure. Some articles had missing information on: amount of gastric aspirate; aspiration before or after solution injection; solution used for gastric aspiration; buffer solution used; and waiting time between specimen collection and laboratory processing. These results showed inconsistencies of gastric lavage protocols. CONCLUSIONS:Although gastric lavage is a secondary diagnostic approach used only in special cases that did not reach the diagnostic scoring as recommended by the Brazilian Ministry of Health, there is a need to standardize gastric lavage protocols for the diagnosis of pulmonary tuberculosis in children.

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Diagnostic Contribution of Gastric and Bronchial Lavage Examinations in Cases Suggestive of Pulmonary Tuberculosis

Cited by 13 publications

References 0 publications

Gastric specimens for diagnosing tuberculosis in adults unable to expectorate in Rawalpindi, Pakistan

Gastric specimens for diagnosing tuberculosis in adults unable to expectorate in Rawalpindi, Pakistan

Does Neutralization of Gastric Aspirates from Children with Suspected Intrathoracic Tuberculosis Affect Mycobacterial Yields on MGIT Culture?

Coleta de lavado gástrico para diagnóstico de tuberculose pulmonar infantil: revisão sistemática

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