Role of gastric aspirate for bacteriological confirmation of pulmonary tuberculosis in hospitalized pre-school children

Abstract

Introduction: Tuberculosis (TB) is an infectious disease caused by Mycobacterium TB (MTB). India accounts for one-fourth of the global TB burden, i. e., 2.2 million out of 9.6 million new cases annually. Objectives: The aim of this study was to assess the role of gastric aspirate (GA) for bacteriological confirmation of pulmonary TB (PTB) in hospitalized preschool children. Methods: A total of 66 consecutive preschool children hospitalized for suspected PTB were included in the study. These patients were prospectively evaluated with a detailed medical history, anthropometric assessment, physical examination and relevant investigations, including complete blood count, erythrocyte sedimentation rate, tuberculin skin test (TST), chest radiograph and GA on three consecutive mornings for smear and culture of MTB. Results: Out of 66 TB suspects, 20 (30.3%) cases were discharged on antitubercular treatment (ATT) based on clinical, laboratory, TST radiological and bacteriological criteria while 46 (69.7%) cases were discharged with an alternative diagnosis. Among cases discharged on ATT, 5 (25%) cases were bacteriologically confirmed on GA smear and culture for acid-fast bacilli (confirmed cases), and 15 (75%) cases were smear negative (probable cases). Out of 5 bacteriologically confirmed cases, 4 (80%) were in the age group 0-2 years, and 1 (20%) case was in the age group 4-6 years. Conclusion: GA remains a useful diagnostic technique for bacteriological confirmation in young children suspected to have PTB, especially in the inpatient setting. It is cheap, simple to perform and requires no special equipment.