Dados do Trabalho

Título

SAFETY AND EFFICAFY OF INDUCED SPUTUM TO OBTAIN SAMPLE FOR MYCOBACTERIUM TUBERCULOSIS DETECTION IN CHILDREN

Introdução

Diagnosing tuberculosis (TB), especially the bacteriological confirmation of pulmonary TB, is notoriously difficult in children. Induced sputum (IS) is considered a safe and tolerable procedure, and the major advantage of this specimen is that it comes directly from the site of infection and reflects the lung microbiological organisms. However, the method is still not widely used.

Objetivo (s)

We aimed to describe the safety and efficacy of IS to obtain sputum samples for Mycobacterium tuberculosis detection in children.

Material e Métodos

A cross-sectional study in 22 Brazilian sites. Children between 6 months to <15 years old were enrolled in two types of health services (hospital and TB clinics) from December 2021 to mid-May 2023. The main inclusion criteria for hospitalized participants were admission for lower respiratory tract infection and, for the clinical ones, the referral of suspected tuberculosis. All participants underwent sputum collection to detect Mycobacterium tuberculosis infection using Xpert MTB/RIF Ultra (GeneXpert® Cepheid). The subjects who could not spit spontaneously had the collection done by IS. After the inducing procedure, those who could not expectorate were submitted to a nasopharyngeal aspirate (NPA). The hospitalized participants had a second sputum collection during admission.

Resultados e Conclusão

Four hundred eighty-six participants were screened, and 406 were included, with a median age of 3.7 (IQR: 1.6-7.0). Four hundred fifty-four procedures of IS (326 in admitted and 128 in ambulatorial subjects), 421/454 (92.5%) with NPA aspiration, were done. IS with or without NPA presented low rates of AR: 3 in ambulatorial and 4 in hospitalized subjects (1.7%, 7/406). No severe AR occurred, but there were minor events: outpatient had two epistaxes and one vomiting, while hospitalized presented vomiting, coughing exacerbation, increase in respiratory rate, and one participant gave vomiting in both aspiration procedures. Even with AR, the induced sputum samples were obtained for all participants. Only one hospitalized participant could not complete the second collection due to vomiting. In conclusion, these preliminary results show that IS is safe, feasible, and effective in obtaining sputum samples for Mycobacterium tuberculosis detection in outpatient and hospitalized children.

Palavras-chave

induced sputum, adverse reactions, Mycobacterium tuberculosis, children.

Agradecimentos

This work was supported by the PROADI-SUS in collaboration with Hospital Moinhos de Vento (NUP 25000.012788/2021-61).