Abstract
Even under ideal circumstances, isolation rates of Mycobacterium Tuberculosis (M.Tb) from gastric lavage range from 28% to 40% in children with suspected pulmonary tuberculosis, although rates can rise to 75% in infants [1]. One year prospective study was undertaken in SMGS Hospital, Jammu to compare Induced Sputum (IS) with Gastric lavage (GL) for yield of M.Tb in children with suspected pulmonary tuberculosis. Children aged 6 months to 18 years admitted for chronic cough (more than 28 days) who could not expectorate and had one of the following: household contact (within past 2 years); failure to gain or loss of weight (in 3 months); Positive mantoux test (>10 mm); Chest radiography with pleural effusion, lymphadenopathy or nonresolving consolidation, were included in the study. Sixty-five children were initially included. Sixty children in whom successful sputum induction (SI) was possible took part in the study. They underwent GL and SI on three consecutive days according to a standard protocol [2]. Children underwent morning GL after an overnight fast of at least 4 h. Gastric aspirate was immediately placed in a tube containing sodium carbonate. SI was undertaken after 2–3 h fast about 6 h after GL. Sputum was obtained by suctioning through nasopharynx after chest percussion. Samples were subjected to decontamination (Petroff’s method) and centrifugation. Treated specimens were inoculated simultaneously on Lowenstein Jenson (LJ) medium and in Middlebrook 7 H9 media (MB7H9). Mycobacterial presence was confirmed by Acid Fast Bacilli (AFB) on direct smears or culture media. Classification as M.Tb was made by typicality of colony morphology and a positive niacin test. The median age of children was 4 years. Samples from IS to GL were positive in 8 (13%) and 5 (8%) children, respectively. The difference between yields for M.Tb from AFB smears to cultures on IS and GL was statistically insignificant (p=0.99) using the χ test. Zar HJ, et al. noted that SI was more sensitive than GL, detecting almost twice the number of children with pulmonary tuberculosis [3]. U. A. Qureshi (*) Department of Neonatology and Pediatrics, SKIMS, Post Box no 1402, GPO Srinagar, Kashmir, India e-mail: dromarqureshi@rediffmail.com
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