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(Chest. 2001;119:1434-1438.)
© 2001 American College of Chest Physicians

Microbiology of Pediatric Primary Pulmonary Tuberculosis*

José M. Merino, MD; Teresa Alvarez, MD; Manuel Marrero, MD; Sara Ansó, MD; Ana Elvira, MD; Gemma Iglesias, MD and José B. González, MD

* From the Pediatric Department, Hospital General Yagüe, Burgos, Spain.

Correspondence to: José M. Merino, MD, Pediatric Department, Hospital General Yagüe, Avda. del Cid, 96, 09005 Burgos, Spain; e-mail: jmmerino{at}hgy.es

Objective: To determine the sensitivity of bacteriologic studies in pediatric pulmonary tuberculosis.

Patients and methods: Between January 1988 and December 1996, 104 consecutive patients aged 0 to 18 years received a diagnosis of primary pulmonary tuberculosis at our institution. Demographic, clinical, laboratory, and bacteriologic data were collected. Clinical specimens were studied for acid-fast bacilli detection by Ziehl-Neelsen stain and cultured for Mycobacterium recovery by Lowenstein-Jensen culture medium. Statistical analysis was performed utilizing {chi}2, t tests, and multivariate logistic regression analysis.

Results: Bacteriologic results were available for 57 patients (54.8%). A positive smear or culture result for Mycobacterium tuberculosis was obtained in 9 of 54 patients (16.6%) and 25 of 50 patients (50%), respectively. Confirmation of M tuberculosis disease was achieved in 28 patients (49.1%). Ziehl-Neelsen stain and Lowenstein-Jensen culture recovery rates were 10.3% (14 of 135) and 52% (48 of 92) of specimens studied, respectively. Sputum, pleural fluid, and biopsy material cultures yielded M tuberculosis in 55%, 75%, and 63% of patients, respectively. Mean ± SD age (13.7 ± 4.5 years vs 9.6 ± 4.5 years) and number of samples submitted for culture (1.93 ± 0.94 vs 1.31 ± 0.97) were significantly higher in the confirmed tuberculosis disease group (p < 0.05). The presence of a pleural effusion was also more commonly found in the confirmed tuberculosis disease group (p < 0.05).

Conclusion: The sensitivity of bacteriologic studies in pediatric pulmonary tuberculosis disease was 49.1%. Age is the main factor associated with the positivity of culture results.

Key Words: bacteriology • children • Lowenstein • tuberculosis • Ziehl-Neelsen




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D. Dogru, U. Ozcelik, A. Gocmen, and J. M. Merino
Pediatric Primary Pulmonary Tuberculosis
Chest, May 1, 2002; 121(5): 1722 - 1722.
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