Gastric culture

Definition 
A gastric culture tests the stomach (gastric) contents in children to identify the microoganism that causes tuberculosis (mycobacterium tuberculosis).

How the test is performed 
A naso-gastric tube is placed through the nose into your child’s stomach. Your child may be given a glass of water and asked to swallow while the tube is advanced. Once the tube is in the stomach, a syringe is used to withdraw a sample. The tube is then removed through the nose, and the sample is taken to the laboratory.

How to prepare for the test 
Your child will need to fast for 8 to 10 hours before the test. The sample is collected in the morning. Conducting the test too soon after the tube is placed can affect the results. For this reason, your child will likely be admitted to the hospital for the night. The tube can then be placed in the evening, and the test performed first thing in the morning.

The preparation you can provide for this test depends on your child’s age, previous experiences, and level of trust. For specific information regarding how you can prepare your child, see the following topics:

     
  • Infant test or procedure preparation (birth to 1 year)  
  • Toddler test or procedure preparation (1 to 3 years)  
  • Preschooler test or procedure preparation (3 to 6 years)  
  • Schoolage test or procedure preparation (6 to 12 years)  
  • Adolescent test or procedure preparation (12 to 18 years)

How the test will feel  
While the tube is being passed through the nose and throat, your child may feel some discomfort and may also feel the urge to vomit.

Why the test is performed 
This test is useful in the diagnosis of pulmonary (lung) tuberculosis in children in whom an adequate sputum sample cannot be obtained.

Normal Values  
The microoganism that causes tuberculosis is not normally present in gastric culture.

What abnormal results mean  

The diagnosis of tuberculosis is made if Mycobacterium tuberculosis, the microoganism that causes tuberculosis, is grown from the gastric culture. Because this bacteria is slow to grow, it may take up to 6 weeks for the diagnosis to be confirmed. There are other mycobacteria that do not cause tuberculosis which may also be detected by this test.

What the risks are  
Anytime a naso-gastric tube is inserted down the back of the throat, there is a small chance that the tube will enter the trachea instead of the esophagus. If this happens, your child may cough, gasp, and have trouble breathing. This is reversed by taking the tube out. There is also a small chance that some of the stomach contents may enter the lung.

Special considerations  

A preliminary test, called an “AFB smear,” will be performed immediately on the sample, and if the results are positive, treatment is usually started right away. A negative AFB smear result, however, does not rule out tuberculosis.

The final results of the gastric culture test may not be known for 6 weeks, as it may take that long for the tuberculosis microoganism to grow. Your physician will decide whether to start treatment before the test results are known.

Johns Hopkins patient information

Last revised: December 4, 2012
by Janet G. Derge, M.D.

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