Murdoch DR
Morpeth SC
Hammitt LL
Driscoll AJ
Watson NL
Baggett HC
Brooks WA
Deloria Knoll M
Feikin DR
Kotloff KL
Levine OS
Madhi SA
O'Brien KL
Scott JAG
Thea DM
Adrian PV
Ahmed D
Alam M
Awori JO
DeLuca AN
Higdon MM
Karron RA
Kwenda G
Machuka EM
Makprasert S
McLellan J
Moore DP
Mwaba J
Mwarumba S
Park DE
Prosperi C
Sangwichian O
Sissoko S
Tapia MD
Zeger SL
Howie SRC
Perch Study Group
Clin Infect Dis. 2017;64S280-S288
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.
