{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T23:16:00Z","timestamp":1791155760119,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2003,5,21]],"date-time":"2003-05-21T00:00:00Z","timestamp":1053475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2003,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Sputum induction is a standard diagnostic procedure to identify pathogens in lower respiratory tract secretions in adults with pneumonia, but has rarely been studied or used in infants and young children. Our aim was to determine the usefulness of induced sputum (IS) as a diagnostic method for infants and children hospitalized with community\u2010acquired pneumonia (CAP) in a high HIV prevalence area. Children hospitalized for CAP were prospectively enrolled over a year. IS was obtained by nebulization with hypertonic (5%) saline, physiotherapy, and suctioning. Sputum was submitted for bacterial and mycobacterial culture and <jats:italic>P. carinii<\/jats:italic> detection. Gastric lavages (GLs) were done for <jats:italic>M. tuberculosis<\/jats:italic> culture; a nasopharyngeal aspirate (NPA) was obtained for bacterial culture and <jats:italic>P. carinii<\/jats:italic> detection. IS was obtained in 210 children (median age, 7 (25th to 75th percentile, 3\u201318) months); 138 (66%) were HIV\u2010infected; 148 (70%) were receiving supplemental oxygen. Bacteria were isolated from 101 (50%) IS and 141 (70%) NPA paired specimens (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). A significantly higher rate of <jats:italic>S. aureus<\/jats:italic>, <jats:italic>H. influenzae<\/jats:italic>, <jats:italic>M. catarrhalis<\/jats:italic>, and <jats:italic>S. pneumoniae<\/jats:italic> was found in NPAs compared to IS; this pattern was particularly evident in HIV\u2010infected children. <jats:italic>M. tuberculosis<\/jats:italic> was cultured from sputum in 19 patients (9%); GLs performed in 142 children were positive in only 9 (6%). The difference (95% confidence interval) between yields for <jats:italic>M. tuberculosis<\/jats:italic> from culture of IS compared to GL was 4.3% (95% CI, 0\u20135.6%; <jats:italic>P<\/jats:italic>\u2009=\u20090.08). <jats:italic>P. carinii<\/jats:italic> was identified from IS in 12 (5.7%) children; all corresponding NPAs were negative. Seven (3%) children could not tolerate sputum induction. Side effects included increased coughing in 4%, epistaxis in 3%, and wheezing responsive to bronchodilators in 1%. In conclusion, induced sputum is a useful and safe diagnostic procedure in infants and children with CAP from a high HIV prevalence area. Pediatr Pulmonol. 2003; 36:58\u201362. \u00a9 2003 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ppul.10302","type":"journal-article","created":{"date-parts":[[2003,5,23]],"date-time":"2003-05-23T10:02:50Z","timestamp":1053684170000},"page":"58-62","source":"Crossref","is-referenced-by-count":58,"title":["Sputum induction as a diagnostic tool for community\u2010acquired pneumonia in infants and young children from a high HIV prevalence area"],"prefix":"10.1002","volume":"36","author":[{"given":"H.J.","family":"Zar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Tannenbaum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Hanslo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Hussey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,5,21]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000029482"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200011000-00015"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2001.tb00270.x"},{"key":"e_1_2_1_5_2","volume-title":"Acute respiratory infections in children: case management in small hospitals in developing countries (WHO\/ARI\/90.5)","author":"World Health Organisation","year":"1990"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.82.4.305"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200007000-00004"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199810000-00005"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1977.02120210080017"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1950030609"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0163-4453(92)90954-5"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(89)80848-0"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/44.6.338"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-5231(05)70234-3"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.163.7.at1010"},{"key":"e_1_2_1_16_2","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1080\/1120009X.1992.11739166","article-title":"Microbiological considerations of the etiological agents of lower respiratory tract infections","volume":"4","author":"Pelligrino M","year":"1992","journal-title":"J Chemother"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1086\/318151"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.26.5.846-849.1988"},{"key":"e_1_2_1_19_2","doi-asserted-by":"crossref","first-page":"2671","DOI":"10.1001\/jama.1978.03280520043015","article-title":"Accuracy of Gram stain in identifying pneumococci in sputum","volume":"239","author":"Rein MF","year":"1978","journal-title":"JAMA"},{"key":"e_1_2_1_20_2","first-page":"997","article-title":"Quantitative culture and Gram stain of sputum in pneumonia","volume":"118","author":"Guckian JC","year":"1978","journal-title":"Am Rev Respir Dis"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200201040-00013"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fppul.10302","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.10302","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T00:24:44Z","timestamp":1700267084000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.10302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,5,21]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2003,7]]}},"alternative-id":["10.1002\/ppul.10302"],"URL":"https:\/\/doi.org\/10.1002\/ppul.10302","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,5,21]]}}}