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String test: A new tool for tuberculosis diagnosis and drug-resistance detection in children

By Belén Rocío Imperiale, Cecilia Nieves, Belén Mancino, Myriam Sanjurjo, Silvina Tártara, ÁngelaBeatríz Di Giulio, JuanCarlos Palomino, NoraSusana Morcillo and Anandi Martin

Abstract

Background: There is a critical need to improve the diagnostic accuracy of tuberculosis (TB) in children. Several techniques have been developed to improve the quality of sputum samples; however, these procedures are very unpleasant and invasive and require hospitalization and trained personnel. This study aims to explore the potential use of a new and noninvasive tool, 'string test,' for TB diagnosis in children and in adults not able to render sputum samples and at risk of developing multidrug-resistant TB (MDR-TB). Methods: Children with clinical suspicion of TB attending the pediatric consultation at the Cetrangolo or Cordero Hospitals and adults suspected of MDR-TB and unable to produce sputum attending the Infectious Disease Unit of Cetrangolo Hospital were included in this study. Subjects and Methods: The 'string test' is a string that is swallowed by the patients and exposed to gastrointestinal secretions that were late analyzed for TB diagnosis and drug-resistance detection by GenoType MTBDRplus. MedCalc software was used to perform statistical analysis. Results: This technique could be applied on 62.1% of selected children. About 11 (30.6%) children were diagnosed as TB cases, 8 (22.2%) from gastric aspirate and using the 'string test.' Six out of 19 adults were also diagnosed. Genotype directly on the string specimen detected two MDR-TB in adults and two isoniazid-resistant cases before obtaining the isolate. Conclusion: This test was safe, cheap, and easily implemented without requiring hospitalization. This research could represent a significant step forward to diagnose and rapidly detect drug-resistant TB in children.Fil: Imperiale, Belén Rocío. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Nieves, Cecilia. Provincia de Buenos Aires. Ministerio de Salud. Hospital "Dr. Antonio A. Cetrángolo"; ArgentinaFil: Mancino, Belén. Provincia de Buenos Aires. Ministerio de Salud. Hospital "Dr. Antonio A. Cetrángolo"; ArgentinaFil: Sanjurjo, Myriam. Provincia de Buenos Aires. Ministerio de Salud. Hospital "Dr. Antonio A. Cetrángolo"; ArgentinaFil: Tártara, Silvina. Provincia de Buenos Aires. Ministerio de Salud. Hospital "Dr. Antonio A. Cetrángolo"; ArgentinaFil: Di Giulio, ÁngelaBeatríz. Hospital Cordero; ArgentinaFil: Palomino, JuanCarlos. Ghent University; BélgicaFil: Morcillo, NoraSusana. Provincia de Buenos Aires. Ministerio de Salud. Hospital "Dr. Antonio A. Cetrángolo"; ArgentinaFil: Martin, Anandi. Université Catholique de Louvain; Bélgic

Topics: CHILDREN, DIAGNOSIS, DRUG-RESISTANCE, STRING-TEST, TUBERCULOSIS, Bioquímica y Biología Molecular, Medicina Básica, CIENCIAS MÉDICAS Y DE LA SALUD
Publisher: 'Medknow'
Year: 2018
DOI identifier: 10.4103/ijmy.ijmy_54_18
OAI identifier: oai:ri.conicet.gov.ar:11336/95942
Provided by: CONICET Digital
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