Effectiveness of inhaled hypertonic saline application for sputum induction to improve Mycobacterium tuberculosis identification in patients with pulmonary tuberculosis

Abstract

<b>The objective:</b> of this study was to assess the effectiveness and diagnostic significance of hypertonic (7%) saline sputum induction for improving <i>MTB</i> detection. <b>Methods:</b> Patients were divided into two groups. Group 1 included patients inhaled a 7% sodium chloride solution upon admission to the hospital with the performance of bacterioscopic, bacteriological and molecular genetic studies on the next day. Group 2 consisted of patients who coughed up their sputum. <b>Results:</b> In this study, 644 patients, were randomly divided into two groups. Low-quality sputum samples were observed in 7.4% of patients from group 1 and 28.8% in the control group (p&lt;0.001). Acid-fast bacilli (AFB) smear was positive in 65.1% of patients from group 1 and 51.3% of individuals from group 2 (p=0.002). A similar statistically significant situation was observed when culture methods (93.9% for group 1 and 81.9% for group 2,p&lt;0.001) and the molecular genetic tests (92.2% for group 1 and 79.4% for group 2,p&lt;0.001) were used. Thus, active pulmonary TB was not verified microbiologically in 6.1% of patients from group 1 and 18.1% of persons from the control group (p&lt;0.001). <b>Conclusions:</b> Hypertonic (7%) saline sputum induction improves the quality of the samples collected. This method may be appropriate to increase the rate of MTB detection in sputum using microscopic, bacteriological, and molecular genetic methods for diagnosing TB on the day of specimen collection. Hypertonic saline sputum induction is more suitable for middle- and low-income countries with limited resources. Furthermore, it causes no severe adverse effects in TB patients.