Informative value of rapid microbiological diagnostic tests and experience in studying a procalcitonin assay in the evaluation of the activity of a mycobacterial population in children and adolescents with destructive pulmonary tuberculosis

The performed investigation showed that the specific feature of a group of children and adolescents with destructive pulmonary tuberculosis is the frequent absence of sputum (64.7%). The informative value of sputum examination for Mycobacterium tuberculosis (MBT) DNA by a polymerase chain reaction assay was significantly higher than that of oropharyngeal lavage (100 and 20.5%, respectively; p < 0.001). Drug resistance in MBT was determined by a microarray test in only 16 (23.5%) out of 68 patients for lack or paucity of DNA in the diagnostic material. Initial chemotherapy regimens were used in these patients in terms of definite resistance. In the other 52 (72.5%) cases, empirical chemotherapy regimens taking into account the possible risk for drug resistance in MBT from their history data and clinical and X-ray findings were given before drug resistance tests or in the absence of bacterial excretion. The first estimates of procalcitonin levels in the children and adolescents with destructive pulmonary tuberculosis may suggest that the positive tests are indicative of the high activity of a mycobacterial population. In the patients with positive procalcitonin tests, unlike those with negative ones, bacterial excretion was significantly more frequently detected by both luminescence microscopy and inoculation Bactec MGIT 960: 85.7 and 20.8%, respectively (p < 0.001), 100 and 50.0%, respectively (p < 0.005).

destructive tuberculosis, children, adolescents, drug-resistant Mycobacterium tuberculosis, procalcitonin

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