PNEUMOCYSTIS CARINII BY INDUCED SPUTUM IN IMMUNOSUPPRESSED PEDIATRIC PATIENTS

免疫抑制儿科患者诱发痰引起的卡氏肺囊虫

• 批准号: 6103548
• 负责人: F P OGNIBENE
• 金额: --
• 依托单位: CLINICAL CENTER
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6103548
• 关键词: HIV infections; Pneumocystis carinii; Pneumocystis pneumonia; child (0-11); clinical research; communicable disease diagnosis; diagnosis design /evaluation; diagnosis procedure safety; dosage forms; expectorant /mucolytic; human subject; immunosuppression; pediatric AIDS; respiratory disorder diagnosis; sodium chloride; sputum; ultrasonography

Immunocompromised pediatric patients with HIV infection and other immunosuppressive disorders are susceptible to Pneumocystis carinii (P. carinii) pneumonia. Bronchoscopy with bronchoalveolar lavage (BAL) may be technically more difficult in pediatric patients. Because of this, an alternative diagnostic method that was safe and reliable had to be determined. We have continued our prospective assessment of the utility of sputum induction for the diagnosis of P. carinii pneumonia in children. An ultrasonic nebulization technique using sodium chloride with either expectoration, or oropharyngeal or nasopharyngeal suctioning has been employed. The project was ongoing, and a major goal was to further improve the sampling technique to increase sensitivity. The medical records of 121 patients aged 4 months to 18 years who underwent sputum induction from January 1990 to December 1994 were reviewed. There were 196 sputum inductions in 121 patients: 28 were positive for P. carinii, 167 were negative, and one collection was insufficient. Of the 167 negative sputum inductions, 57 were followed by BAL, of which 10 were P. carinii positive. The 157 patient encounters which were negative for P. carnii by sputum induction or BAL were followed for 1 month: 150 remained negative for P. carinii, 2 became P. carinii positive, and 5 had no information available. The overall sensitivity of sputum induction was 70 percent, and the negative predictive value was 93 percent. We concluded that sputum induction is an effective and fairly sensitive diagnostic technique in this group of pediatric patients and should be the initial diagnostic procedure in immunosuppressed pediatric patients suspected of having P. carinii pneumonia. This project has extended the clinical applicability of a diagnostic procedure, developed largely by NIH. It now offers many centers the option of a test that is less expensive, less invasive, and less associated with complications than bronchoscopy. The project is completed, and a manuscript has been submitted.

免疫功能低下的儿童艾滋病毒感染者 感染和其它免疫抑制病症易受 卡氏肺孢子虫肺炎。支气管镜检查伴 支气管肺泡灌洗（BAL）在技术上可能更困难， 儿科患者。因此，另一种诊断方法 是安全可靠的。我们继续 我们前瞻性评估了痰诱导的效用， 小儿卡氏肺孢子虫肺炎的诊断超声波 使用氯化钠雾化技术， 咳痰，或口咽或鼻咽吸痰， 被雇用了。该项目正在进行中，主要目标是 进一步改进采样技术，提高灵敏度。的 121例4个月至18岁的患者的病历， 1990年1月至1994年12月进行了痰诱导 综述了121例患者进行了196次痰液诱导： 卡氏肺孢子虫阳性28例，阴性167例， 收藏不足。在167例阴性痰诱导中， 57例行BAL，其中10例卡氏肺孢子虫阳性。的 157例患者的痰液检测结果为卡氏肺孢子虫阴性 诱导或BAL随访1个月：150例保留 卡氏肺孢子虫阴性，2例卡氏肺孢子虫阳性，5例无 information available.痰诱导的总体敏感性 是70%，阴性预测值是93%。 我们认为诱导痰是一种有效的， 敏感的诊断技术在这组儿科患者和 应该是免疫抑制的初始诊断程序 疑似卡氏肺孢子虫肺炎的儿科患者。这 该项目扩大了诊断的临床适用性， 主要由NIH开发的程序。它现在提供了许多中心 一种更便宜、侵入性更小、 与支气管镜检查的并发症有关。该项目 已完成，并提交了一份手稿。