@article{9095814eedd043d1aba9d53896b701b1,
title = "The diagnostic utility of induced sputum microscopy and culture in childhood pneumonia",
abstract = "Background. Sputum microscopy and culture are commonly used for diagnosing the cause of pneumonia in adults but are rarely performed in children due to difficulties in obtaining specimens. Induced sputum is occasionally used to investigate lower respiratory infections in children but has not been widely used in pneumonia etiology studies. Methods. We evaluated the diagnostic utility of induced sputum microscopy and culture in patients enrolled in the Pneumonia Etiology Research for Child Health (PERCH) study, a large study of community-acquired pneumonia in children aged 1-59 months. Comparisons were made between induced sputum samples from hospitalized children with radiographically confirmed pneumonia and children categorized as nonpneumonia (due to the absence of prespecified clinical and laboratory signs and absence of infiltrate on chest radiograph). Results. One induced sputum sample was available for analysis from 3772 (89.1%) of 4232 suspected pneumonia cases enrolled in PERCH. Of these, sputum from 2608 (69.1%) met the quality criterion of <10 squamous epithelial cells per low-power field, and 1162 (44.6%) had radiographic pneumonia. Induced sputum microscopy and culture results were not associated with radiographic pneumonia, regardless of prior antibiotic use, stratification by specific bacteria, or interpretative criteria used. Conclusions. The findings of this study do not support the culture of induced sputum specimens as a diagnostic tool for pneumonia in young children as part of routine clinical practice.",
keywords = "Children, Culture, Induced sputum, Microscopy, Pneumonia",
author = "{PERCH Study Group} and Murdoch, {David R.} and Morpeth, {Susan C.} and Hammitt, {Laura L.} and Driscoll, {Amanda J.} and Watson, {Nora L.} and Baggett, {Henry C.} and Brooks, {W. Abdullah} and Knoll, {Maria Deloria} and Feikin, {Daniel R.} and Kotloff, {Karen L.} and Levine, {Orin S.} and Madhi, {Shabir A.} and O'Brien, {Katherine L.} and Scott, {J. Anthony G.} and Thea, {Donald M.} and Adrian, {Peter V.} and Dilruba Ahmed and Muntasir Alam and Awori, {Juliet O.} and DeLuca, {Andrea N.} and Higdon, {Melissa M.} and Karron, {Ruth A.} and Geoffrey Kwenda and Machuka, {Eunice M.} and Sirirat Makprasert and Jessica McLellan and Moore, {David P.} and John Mwaba and Salim Mwarumba and Park, {Daniel E.} and Christine Prosperi and Ornuma Sangwichian and Seydou Sissoko and Tapia, {Milagritos D.} and Zeger, {Scott L.} and Howie, {Stephen R.C.} and Nicholas Fancourt and Wei Fu and Kagucia, {E. Wangeci} and Mengying Li and Zhenke Wu and Jane Crawley and Endtz, {Hubert P.} and Khalequ Zaman and Doli Goswami and Lokman Hossain and Yasmin Jahan and Hasan Ashraf and Ebruke, {Bernard E.} and Martin Antonio",
note = "Funding Information: Supplement sponsorship. This article appears as part of the supplement “Pneumonia Etiology Research for Child Health (PERCH): Foundational Basis for the Primary Etiology Results,” sponsored by a grant from the Bill & Melinda Gates Foundation to the PERCH study of Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Funding Information: Financial support. PERCH was supported by a grant from the Bill & Melinda Gates Foundation to the International Vaccine Access Center, Department of International Health, Johns Hopkins Bloomberg School of Public Health (grant 48968). J. A. G. S. was supported by a clinical fellowship from the Wellcome Trust of Great Britain (098532). Publisher Copyright: {\textcopyright} The Author 2017.",
year = "2017",
doi = "10.1093/cid/cix090",
language = "English (US)",
volume = "64",
pages = "S280--S288",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
}