Efficacy of sputum induction from lower respiratory tract in children
Abstract
Background Although sputum is a good specimen for various
examinations, such as cytology and microbiological culture,
sputum induction (SI) is not a routine procedure in children.
Objective To identify the efficacy of SI to obtain specimen from
lower respiratory tract in children, identify side effects of SI, and
the results of microbiological examination.
Methods A cross sectional study was performed in children (aged
1 month to 18 years) who underwent SI. Sputum induction was
performed by inhalation with hypertonic solution, consisted of
salbutamol for 15 minutes continued with NaCl 3% solution
for another 15 minutes. Sputum specimens were examined for
number of alveolar macrophage cell, surfactant protein A (SP-A)
concentration, also acid-fast bacili smear, and M. tuberculosis
culture, or aerobic microbial culture.
Results Forty subjects with lower respiratory tract infection
participated in this study, and SI was succesfully performed in
all subjects. Youngest subject was 2 month old, the eldest was 16
year 7 month old. Median duration of SI was 45 minutes, and
majority of volume was 3 or 4 mL. Side effects were nosebleeds
(40%) and vomiting (2.5%). Macrophage alveolar more than 5
cells in one specimen was found in 97.5% subjects. Surfactant
protein A examination was performed in 30 specimens, and SP-A
was detected in all specimens (median concentration 264.528 pg/
mL). Culture for M. tuberculosis was positive in 1 of 27 subjects,
while acid fast bacili smear was negative in all examined subjects.
Aerobic microbial culture was positive in 5 of 13 subjects.
Conclusions Sputum induction has good efficacy in obtaining
lower respiratory tract specimen and it is safe to perform in
children. Specimen from sputum induction yields good positive
result for aerobic microbial cultures.
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Accepted 2016-06-29
Published 2015-04-30
