Details

Autor(en) / Beteiligte

• Hoppe, Jordana E.
• Towler, Elinor
• Wagner, Brandie D.
• Accurso, Frank J.
• Sagel, Scott D.
• Zemanick, Edith T.

Titel

Sputum induction improves detection of pathogens in children with cystic fibrosis

Ist Teil von

• Pediatric pulmonology, 2015-07, Vol.50 (7), p.638-646

Ort / Verlag

United States: Blackwell Publishing Ltd

Erscheinungsjahr

2015

Link zum Volltext

Quelle

Wiley Online Library

Beschreibungen/Notizen

• Summary Background Sputum induction is a safe, well tolerated means of obtaining lower airway secretions from children with cystic fibrosis (CF), particularly for assessment of airway inflammation but the clinical value in diagnosing outpatient infections has not been extensively studied. Objectives Investigate the success rate and microbiologic yield of induced sputum (IS) compared to oropharyngeal swabs (OP) and expectorated sputum (ES) samples in children with CF, and determine if IS culture results impact treatment. Methods Two cohorts were included in this prospective, longitudinal comparative study. In one cohort, simultaneously collected OP, ES, and IS specimens were obtained from 17 CF children at three visits over 1 year. In the second group, sputum induction was performed in 35 CF subjects at four annual visits, and culture results were compared to their nearest respiratory culture within 4 months. Antimicrobial treatment regimens were captured retrospectively. Results Sputum induction was successful in 149 of 158 (94%) visit encounters. Polymicrobial infection (combined P = 0.005) and gram negative organisms (combined P = 0.003) were detected more frequently in IS samples compared to OP, as were the individual pathogens Pseudomonas aeruginosa (combined P = 0.04) and Stenotrophomonas maltophilia (combined P = 0.05). The microbiologic yield of serial IS samples collected over 1 year was stable. IS culture results led to antibiotic changes in 6% of visit encounters. However, based on current practice 13% of visits could have resulted in treatment changes. Conclusions Sputum induction is feasible in the outpatient setting and appears to improve pathogen detection in children with CF. Pediatr Pulmonol. 2015; 50:638–646. © 2015 Wiley Periodicals, Inc.