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12.08.2021 | original article

Effectiveness of inhaled hypertonic saline application for sputum induction to improve Mycobacterium tuberculosis identification in patients with pulmonary tuberculosis

verfasst von: MD PhD ScD Prof. Dr. Dmytro Butov, MD PhD ScD Prof. Dr. Yurii Feshchenko, MD PhD ScD Prof. Dr. Valeriy Myasoedov, MD PhD ScD Prof. Dr. Mykhailo Kuzhko, MD PhD ScD Prof. Dr. Mykola Gumeniuk, MD PhD ScD Prof. Dr. Galyna Gumeniuk, MD PhD Dr. Anton Tkachenko, MD PhD ScD Dr. Nekrasova Nataliya, Olena Borysova, MD PhD Dr. Tetiana Butova

Erschienen in: Wiener Medizinische Wochenschrift

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Summary

Background

This study assessed the effectiveness and diagnostic significance of hypertonic saline sputum induction for improving Mycobacterium tuberculosis (MTB) detection.

Methods

A prospective, randomized, open, two-arm, comparative study on MTB identification effectiveness when using inhaled sodium chloride hypertonic solution was performed in patients diagnosed with pulmonary tuberculosis (TB). Patients were randomly assigned into two groups: group 1 (inhalation group) included patients who inhaled a 7% sodium chloride solution upon admission to the hospital, and group 2 (control group) coughed up their sputum as usual. For both groups, specimens were tested by bacterioscopic, bacteriological, and molecular genetic methods. Diagnostic chest radiography was performed for all participants.

Results

In this study, 644 patients (mean age 42.2 years; 151 women, 23.4%) were randomly divided into two groups. Low-quality sputum samples were observed in 7.4% of patients from the inhalation group and 28.8% in the control group (p < 0.001). Acid-fast bacilli (AFB) smear was positive in 65.1% of patients from the inhalation group and 51.3% of controls (p = 0.002). A similar statistically significant situation was observed when culture methods (93.9% inhalation group and 81.9% control group, p < 0.001) and molecular genetic tests (92.2% inhalation group and 79.4% control group, p < 0.001) were used. Thus, active pulmonary TB was not verified microbiologically in 6.1% of patients from the inhalation group and in 18.1% of controls (p < 0.001).

Conclusions

Hypertonic saline sputum induction improves the quality of collected samples. This method may be appropriate to increase the rate of MTB detection in sputum using microscopic, bacteriological, and molecular genetic methods for diagnosing TB on the day of specimen collection. Hypertonic saline sputum induction is suitable for middle- and low-income countries with limited resources and causes no severe adverse effects in TB patients.

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Metadaten
Titel
Effectiveness of inhaled hypertonic saline application for sputum induction to improve Mycobacterium tuberculosis identification in patients with pulmonary tuberculosis
verfasst von
MD PhD ScD Prof. Dr. Dmytro Butov
MD PhD ScD Prof. Dr. Yurii Feshchenko
MD PhD ScD Prof. Dr. Valeriy Myasoedov
MD PhD ScD Prof. Dr. Mykhailo Kuzhko
MD PhD ScD Prof. Dr. Mykola Gumeniuk
MD PhD ScD Prof. Dr. Galyna Gumeniuk
MD PhD Dr. Anton Tkachenko
MD PhD ScD Dr. Nekrasova Nataliya
Olena Borysova
MD PhD Dr. Tetiana Butova
Publikationsdatum
12.08.2021
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-021-00871-5