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 utilizingχ
2, t tests, and multivariate logistic
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).
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.