Research of childhood tuberculosis in suspected populations by molecular methods: A multicenter study in China

Chunling Li; Shifu Wang; Hui Yu; Jiangxia Wang; Jikui Deng; Hongmei Wang; Chunzhen Hua; Zhiqiang Zhuo; Lei Chen; Jianhua Hao; Wei Gao; Hong Zhang; Ting Zhang; Hongmei Xu; Chuanqing Wang

doi:10.3389/fcimb.2022.1018699

Research of childhood tuberculosis in suspected populations by molecular methods: A multicenter study in China

Front Cell Infect Microbiol. 2022 Oct 19:12:1018699. doi: 10.3389/fcimb.2022.1018699. eCollection 2022.

Authors

Chunling Li¹, Shifu Wang², Hui Yu³, Jiangxia Wang⁴, Jikui Deng⁵, Hongmei Wang⁵, Chunzhen Hua⁶, Zhiqiang Zhuo⁷, Lei Chen⁸, Jianhua Hao⁹, Wei Gao¹⁰, Hong Zhang¹¹, Ting Zhang¹², Hongmei Xu⁴, Chuanqing Wang¹

Affiliations

¹ Clinical Microbiology Laboratory, Children's Hospital of Fudan University, Children's National Medical Center, Shanghai, China.
² Shandong Provincial Clinical Research Center for Children's Health and Disease, Children's Hospital Affiliated to Shandong University, Jinan, Shandong Province, China.
³ Division of Infectious Diseases, Children's Hospital of Fudan University, Children's National Medical Center, Shanghai, China.
⁴ Department of Infection Diseases Children's Hospital of Chongqing Medical University, Chongqing, China.
⁵ Department of Infectious Diseases, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, China.
⁶ Division of Infectious Diseases, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
⁷ Department of Infectious Diseases, Xiamen Children's Hospital (Children's Hospital of Fudan University Xiamen Branch), Xiamen, Fujian Province, China.
⁸ Department of Medical Laboratory Diagnosis Center, Xiamen Children's Hospital (Children's Hospital of Fudan University Xiamen Branch), Xiamen, Fujian Province, China.
⁹ Department of Medical Laboratory Diagnosis Center, Children's Hospital of Kaifeng City, Kaifeng, Henan Province, China.
¹⁰ Department of Infectious Diseases, Children's Hospital of Kaifeng City, Kaifeng, Henan Province, China.
¹¹ Department of Medical Laboratory Diagnosis Center, Children's Hospital of Shanghai Jiaotong University School of Medicine, Shanghai, China.
¹² Institue of Pediatric Infection, Immunity and Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Abstract

The research of childhood tuberculosis is inadequate in china. The cross-priming amplification (CPA) of specific DNA in clinical samples is increasingly adopted for the diagnosis of childhood tuberculosis. In this study, a multicenter research was performed to investigate the incidence and characteristics of childhood tuberculosis in suspected populations mainly by CPA method. 851 children suspected of tuberculosis were enrolled in seven centers across China. All samples were tested by a CPA method and 159 subjects were tested by Xpert MTB/RIF and liquid culture method in parallel to assess the reliability of the CPA method. A positive result in any one of the three methods provided a definitive diagnosis of Mycobacterium tuberculosis complex (MTBC) infection. The MTBC-positive rate was 9.5% (81/851) by the combined methods; 93.8% of the cases were detected by CPA technology (76/81). The rate of pulmonary infection was significantly higher than that of extrapulmonary infection (7.1%, 60/851 vs 2.5%, 21/851; P < 0.001). Scrofula was the predominant type of extrapulmonary tuberculosis. The MTBC positive rates in 12-18-year-old group (middle school), was 28.4% (23/81), higher than in those under-six-year-old (preschool; 39/525) and the 6~11-year-old (primary school; 18/235) groups combined (P < 0.001). The MTBC positive rate in patients with a clear history of tuberculosis exposure was significantly higher than in cases in which there was no history of tuberculosis contact(35.3%, 18/51 vs 7.8%, 61/782; P < 0.001). In conclusion, this multicenter investigation showed that pulmonary tuberculosis and extrapulmonary tuberculosis are not uncommon in children in China, with teenagers being particularly susceptible to infection. The incidence of pulmonary tuberculosis in children is higher than that of extrapulmonary tuberculosis. History of exposure to tuberculosis is a high risk factor for childhood tuberculosis.

Keywords: CPA; children; extrapulmonary tuberculosis; molecular; pulmonary tuberculosis.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Child
Child, Preschool
Humans
Mycobacterium tuberculosis* / genetics
Reproducibility of Results
Sensitivity and Specificity
Sputum / microbiology
Tuberculosis* / diagnosis
Tuberculosis* / epidemiology
Tuberculosis, Pulmonary* / diagnosis
Tuberculosis, Pulmonary* / epidemiology