Zampoli Marco, Pillay Komala, Carrara Henri, Zar Heather J, Morrow Brenda
Department of Paediatrics and Child Health, Division of Pediatric Pulmonology, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Department of Anatomical Pathology, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
J Cyst Fibros. 2016 Sep;15(5):605-10. doi: 10.1016/j.jcf.2016.01.001. Epub 2016 Jan 26.
Standard respiratory sampling in young children with cystic fibrosis (CF) is by oropharyngeal swab (OPS) as they cannot spontaneously expectorate. Sputum induction (IS) has been poorly investigated in this population. We aimed to compare the bacteriological yield of OPS vs. IS in young children with CF.
Sequentially paired OPS followed by IS samples was collected in children <5years of age attending a CF clinic in Cape Town, South Africa.
IS was successfully paired with OPS in 98/113 (85%) attempts in 32 children (mean±SD 19±16months), with no serious adverse events. IS culture yield for any CF-associated bacteria from IS was 46% vs. 28% from OPS (p=0.01). The sensitivity, specificity, PPV and NPV of OPS compared to IS in isolating CF-associated bacteria were 56%, 96%, 93%, and 72% respectively.
Sputum induction is feasible, safe and superior to OPS for detecting CF-associated bacteria in young children with CF.
患有囊性纤维化（CF）的幼儿无法自主咳痰，因此标准的呼吸道采样方法是咽拭子采样（OPS）。对于这一人群，诱导痰采样（IS）的研究较少。我们旨在比较CF幼儿中OPS与IS的细菌学检出率。
在南非开普敦一家CF诊所就诊的5岁以下儿童中，依次采集配对的OPS样本和IS样本。
在32名儿童（平均±标准差19±16个月）的113次尝试中，98次（85%）成功获得了配对的IS样本，且无严重不良事件。IS培养出任何CF相关细菌的检出率为46%，而OPS为28%（p=0.01）。与IS相比，OPS分离CF相关细菌的敏感性、特异性、阳性预测值和阴性预测值分别为56%、96%、93%和72%。
对于CF幼儿，诱导痰采样在检测CF相关细菌方面可行、安全且优于咽拭子采样。
