A Hospital-Based Clinico-Epidemiological Study to Assess the Role of PCR in Diagnosing TB in Children

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Abstract (English)

Abstract Aim: The aim of the present study was to assess the role of PCR in diagnosing TB in children. Methods: This cross-sectional study was carried out in the Upgraded Department Of Pediatrics, Patna Medical College and Hospital, Patna, Bihar, India and included 100 patients aged <15 years who were clinically diagnosed with TB. Duration of study from August 2013 to July 2014 Results: The median (IQR) age of enrolled TB patients (N = 100) was 1.7 (0.75, 3.0) years. Most of them (88%, 88/100) belonged to the <5 years age group; only five (5%) were 10 years old. Fifty-eight percent of participants were male (58/100). The majority (90%, 90/100) had a TBS of 7 according to the TBS chart, and 45% (45/100) had a score of 5 according to the MKJ scoring system. Gastric lavage was collected from 96% of the participants, including all of the children <5 years of age and seven of the 11 children >5 years of age who were unable to produce a spontaneous sputum specimen. Pathogen detection in the children with clinically diagnosed TB, according to the age group and type of respiratory sample. Smear for AFB microscopy and conventional (solid) culture were performed on all respiratory samples collected (N = 100). MGIT culture was performed on 100 samples. Smear microscopy was positive only in three cases and all of them were from gastric lavage. All smearpositive cases were positive by both culture methods. The newer sensitive PCR technique using IS6110 primers was positive for the children and similar positivity was found among younger children. Conclusion: In conclusion, this study demonstrated that the PCR method using IS6110 primers might have greater importance when compared to the performance of smear microscopy in the detection of MTB among younger and nutritionally compromised children, for whom bacteriological confirmation can rarely be achieved. It might also be beneficial in detecting more pathogens within a shorter period of time when compared to the gold standard culture method