Vol 76: Usefulness of Sputum Induction with Hypertonic Saline in a Real Clinical Practice for Bacteriological Yields of Active Pulmonary Tuberculosis.Reportar como inadecuado



 Vol 76: Usefulness of Sputum Induction with Hypertonic Saline in a Real Clinical Practice for Bacteriological Yields of Active Pulmonary Tuberculosis.


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This article is from Tuberculosis and Respiratory Diseases, volume 76.AbstractBackground: Mycobacterial identification in active pulmonary tuberculosis APTB is confirmative, even though successful rates using self-expectorated sputum are limited. Sputum specimens collected by hypertonic saline nebulization showed higher bacteriologic diagnostic sensitivities over those of self-expectoration, mostly studied in smear-negative or sputum-scarce patients. The efficacy of induced sputum was rarely assessed in real clinical settings. Methods: A prospective randomized case-control study was performed in one hospital. The subjects highly suspicious of APTB were asked to provide 3 pairs of sputum specimens in 3 consecutive days. The first pairs of the specimens were obtained either by self-expectoration ES from the next day of the visit or sputum induction with 7% saline nebulization in clinic SI, and the other specimens were collected in the same way. The samples were tested in microscopy, culture, and polymerase chain reaction PCR. The outcomes of the bacteriological diagnosis were compared. Results: Seventy six patients were assigned to either ES 38 subjects, median age of 51, 65.8% male or SI 38 subjects, median age of 55, 52.6% male. APTB was clinically confirmed in 51 patients 70.8%, 27 in ES and 24 in SI. Among the APTB, more adequate specimens were collected from SI 41-65, 63.1% than ES 34-80, 42.5% p=0.01. Bacteriological confirmation was achieved in 14 58.3% patients in SI, and 13 48.1% in ES p=0.46. In the same-day bacteriological diagnosis with microscopy and PCR, there were positive results for 9 patients 37.5% in SI and 7 patients 25.9% in ES p=0.37. Conclusion: Sputum induction improves sputum specimen adequacy. It may be useful for the same-day bacteriological diagnosis with microscopic examination and PCR.



Autor: Seong, Gil Myeong; Lee, Jaechun; Lee, Jong Hoo; Kim, Jeong Hong; Kim, Miok

Fuente: https://archive.org/







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