Induced sputum in the diagnosis of childhood community-acquired pneumonia
Induced sputum in the diagnosis of childhood community-acquired pneumonia
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DOI：
10.1136/thx.2008.099051
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发表时间：
2009-03-01
期刊：
影响因子：
10
通讯作者：
Ruuskanen, O.
中科院分区：
文献类型：
--
作者：
Lahti, E.;Peltola, V.;Ruuskanen, O.
背景：尚未研究诱导痰在寻找儿童肺炎病原体方面的有效性。方法：该研究涉及 101 名年龄在 6 个月至 15 岁之间的儿童，他们于 2006 年 1 月至 2007 年 4 月在图尔库大学医院（芬兰图尔库）接受社区获得性肺炎治疗。首先通过两个鼻孔收集鼻咽吸出物样本。然后通过吸入 5.0% 高渗盐水 5-10 分钟诱导痰液产生，并吸出或咳出痰液样本。采用半定量细菌培养和定量PCR技术对配对鼻咽吸出物和痰标本中细菌和病毒的存在和数量进行分析和比较。结果：从76名儿童中获得了高质量的痰标本。 90% 的病例都找到了可能的病原体。肺炎链球菌（46%）和鼻病毒（29%）是最常见的检测到的微生物。新发现的病毒人类博卡病毒和人类偏肺病毒分别在18%和13%的儿童中检出。四分之一的细菌仅在痰中检出，其余痰标本中的细菌含量与鼻咽吸出物中的细菌含量相比，分别高出 14% 和 70%。痰液中鼻病毒含量比鼻咽吸出液中鼻病毒含量高82%。结论：社区获得性肺炎患儿痰液诱导提供的痰标本质量好，微生物检出率高。诱导痰分析可用于儿童社区获得性肺炎的微生物学诊断。
Background: The usefulness of induced sputum in searching for causative agents of pneumonia in children has not been studied.Methods: The study involved 101 children, aged 6 months to 15 years, treated for community-acquired pneumonia at Turku University Hospital (Turku, Finland) from January 2006 to April 2007. Nasopharyngeal aspirate samples were first collected through both nostrils. Sputum production was then induced by inhalation of 5.0% hypertonic saline for 5-10 min and a sputum sample was either aspirated or expectorated. The presence and amount of bacteria and viruses in paired nasopharyngeal aspirate and sputum specimens was analysed and compared using semiquantitative bacterial culture and quantitative PCR techniques.Results: A good quality sputum specimen was obtained from 76 children. The possible causative agent was found in 90% of cases. Streptococcus pneumoniae (46%) and rhinovirus (29%) were the most common microbes detected. Newly discovered viruses human bocavirus and human metapneumovirus were detected in 18% and 13% of the children, respectively. One-quarter of all bacterial findings were only detected in sputum, and the amount of bacteria in the remainder of the sputum specimens compared with nasopharyngeal aspirate was higher in 14% and equal in 70%. The amount of rhinovirus in sputum was higher than in nasopharyngeal aspirate in 82%.Conclusions: Sputum induction provides good quality sputum specimens with high microbiological yield in children with community-acquired pneumonia. Induced sputum analysis can be useful in the microbiological diagnosis of childhood community-acquired pneumonia.