Detection of Mycobacterium tuberculosis Complex Bacilli and Nucleic Acids From Tongue Swabs in Young, Hospitalized Children

被引:10
|
作者
Ealand, Christopher [1 ,2 ]
Peters, Julian [1 ,2 ]
Jacobs, Olivia [1 ,2 ]
Sewcharran, Astika [1 ,2 ]
Ghoor, Azra [3 ]
Golub, Jonathan [4 ]
Brahmbhatt, Heena [5 ,6 ]
Martinson, Neil [4 ,6 ]
Dangor, Ziyaad [7 ]
Lala, Sanjay G. [6 ,7 ]
Kana, Bavesh [1 ,2 ]
机构
[1] Univ Witwatersrand, Ctr Excellence Biomed TB Res, Natl Res Fdn DSI NRF, Dept Sci & Innovat,Sch Pathol,Fac Hlth Sci, Johannesburg, South Africa
[2] Natl Hlth Lab Serv, Johannesburg, South Africa
[3] Univ Witwatersrand, Fac Hlth Sci, Dept Paediat & Child Hlth, Johannesburg, South Africa
[4] Johns Hopkins Univ, Ctr TB Res, Baltimore, MD USA
[5] US Agcy Int Dev USAID, Pretoria, South Africa
[6] Univ Witwatersrand, Fac Hlth Sci, Perinatal HIV Res Unit PHRUab, Johannesburg, South Africa
[7] Univ Witwatersrand, Fac Hlth Sci, Dept Paediat & Child Hlth, Paediat Educ & Res Ladder, Johannesburg, South Africa
来源
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY | 2021年 / 11卷
基金
英国医学研究理事会; 新加坡国家研究基金会;
关键词
auramine staining; spoligotyping; qPCR; tongue swabs; pediatric tuberculosis; PULMONARY TUBERCULOSIS; GENETIC DIVERSITY; DIAGNOSIS; DATABASE; SPUTUM;
D O I
10.3389/fcimb.2021.696379
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Diagnosis of tuberculosis in pediatric patients remains challenging due to inherent difficulties associated with obtaining respiratory samples for molecular and culture-based testing. To address this, recent studies have highlighted the utility of tongue swabs to detect Mycobacterium tuberculosis genomic DNA in the oral epithelia of tuberculosis infected adults. It is unknown whether tongue swabs have similar utility for diagnosis of childhood tuberculosis and if the presence of DNA in these swabs was associated with whole bacilli. We therefore sought to conduct a preliminary assessment of the utility of tongue swabs to detect tubercle bacilli and their associated genetic material in young children. For this, we recruited hospitalized children with clinically diagnosed tuberculosis (n = 26) or lower respiratory tract infection (LRTI, n = 9). These categories were blinded for downstream laboratory tests, which included PCR, spoligotyping, smear microscopy, and culture. Mtb genomic DNA was detected by PCR only in clinically diagnosed TB cases [11/26 (31.4%)] and not in cases with LRTI. Of these, 5/11 [45.5%] were associated with a spoligotype. Spoligotyping also detected an additional six specimens that were negative by PCR. Using smear microscopy, 19/26 [73.1%] and 4/9 [44.4] were Mtb positive in the tuberculosis or LRTI categories respectively. We noted positive results on all three tests in 5/26 [19.2%] in the tuberculosis category and 0/9 in the LRTI category. All specimens were culture negative. Collectively, these preliminary data present a compelling case for broader testing of tongue swabs to diagnose tuberculosis in children where obtaining standard sputum specimens is not easy.
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页数:9
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