PEDIATRICS Vol. 102 No. 4 October 1998, p. e40

ELECTRONIC ARTICLE:
Detection of Mycobacterium tuberculosis in Gastric Aspirates Collected From Children: Hospitalization Is Not Necessary

Received Mar 2, 1998; accepted May 22, 1998.

Mark N. Lobato^*, , Ann M. Loeffler^§, Karen Furst, Barbara Cole^¶, and Philip C. Hopewell^#,

From the Departments of ^* Pediatrics and ^# Medicine, San Francisco General Hospital, University of California, and  the Francis J. Curry Tuberculosis Center, San Francisco, California; the ^§ Division of Infectious Diseases, Children's Hospital Oakland, Oakland, California; the  Tuberculosis Control Program, San Joaquin County, Public Health Services, Stockton, California; and the ^¶ Tuberculosis Control Program, Riverside Department of Public Health, Riverside, California.

Objective.  To compare the yields of gastric aspirates collected for culture of Mycobacterium tuberculosis from children evaluated as outpatients versus inpatients and to determine factors associated with a positive culture.

Methods.  Retrospective study of 100 children <12 years of age with tuberculosis diagnosed at a pediatric referral hospital or in one of two tuberculosis control programs in California.

Results.  Of the 100 children who had tuberculosis, 80 had at least one gastric aspirate collected. M tuberculosis was isolated from 33 (41%) of the 80 children who had a gastric aspirate; 4 children had a positive culture from an aspirate subsequent to the first. Inpatients had a higher proportion of positive gastric aspirates than that of children who had aspirates collected as outpatients (48% vs 37%); however, this difference was not statistically significant. Resistance to isoniazid was found in three isolates (9%) of children all of whose presumptive source case had a susceptible strain of M tuberculosis. Characteristics that were associated with an ~50% yield from gastric aspirates were identification of a source case, age <2 years, birth in the United States, symptomatic tuberculosis, and pulmonary disease.

Conclusions.  The culture of M tuberculosis from gastric aspirates of children in the outpatient setting has a yield comparable to aspirates collected from hospitalized children. Collection of gastric aspirates in the outpatient setting will reduce both the cost and the inconvenience of the procedure. Although the yield from gastric aspirates is relatively low, important information including drug susceptibility patterns may be obtained. tuberculosis, gastric aspirate, children. .

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