SO SÁNH KHẢ NĂNG PHÁT HIỆN TÁC NHÂN GÂY BỆNH TRONG BỆNH PHẨM HÔ HẤP GIỮA HAI KĨ THUẬT LẤY ĐÀM THƯỜNG VÀ ĐÀM KÍCH THÍCH Ở BỆNH NHÂN NHIỄM HIV/AIDS MẮC VIÊM PHỔI

Abstract

Background: Pneumonia is a leading cause of hospital admissions and deaths among patients with HIV. Determining the causative agent is crucial for providing targeted treatment. Using the induced sputum method to collect sputum or respiratory secretions from pneumonia patients can assist in identifying the responsible pathogen. Objective: To describe the detection rate and compare the effectiveness of conventional sputum collection and induced sputum collection techniques for identifying pathogens in respiratory specimens from HIV/AIDS patients with pneumonia. Methods: A cross-sectional study was conducted on 96 HIV/AIDS inpatients with pneumonia at the Infection Department E of the Hospital for Tropical Diseases from January to June 2020. The study compared the ability to isolate the pathogen between conventional sputum collection and induced sputum collection techniques using the McNemar test, with a statistical significance threshold of p < 0.05. Results: The agents detected in the respiratory fluids of patients were Pneumocystis jirovecii P.jirovecii (50.0%), bacteria (47.9%), Mycobacterium tuberculosis (36.5%), and fungi (18.8%), respectively. There was no difference between the detection rate of P.jirovecii, the rate of positive AFB smear, the rate of culturing Mycobacterium tuberculosis, the rate of collecting standard sputum samples and the rate of positive bacterial cultures between conventional sputum collection and induced sputum collection techniques (p > 0.05). Conclusion:  The agent found in respiratory specimens with the highest rate is P.jirovecii, followed by bacteria, Mycobacterium tuberculosis and fungi. There is no difference in the ability to detect all pathogens in respiratory specimens between conventional sputum collection and induced sputum collection techniques. Therefore, in HIV patients who cannot expectorate normal sputum, aerosol induction can be used to collect induced sputum. This induced sputum sample is as valuable as a normal sputum sample in detecting pathogens.