Department of Pediatrics, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13083-887, Brazil.
Department of Medical Genetics, Faculdade de Ciências Médicas, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Camargo, 126, Cidade Universitária Zeferino Vaz, Campinas, SP, CEP 13083-887, Brazil.
Lung. 2017 Aug;195(4):431-439. doi: 10.1007/s00408-017-0008-3. Epub 2017 Apr 28.
The aim of this study was to compare the qualitative and semi-quantitative detection of pathogens in the airway secretions of patients with cystic fibrosis (CF) and the sputum induction capacity before and after inhalation of 7% hypertonic saline solution (HSS).
The study enrolled 64 patients with CF. Airway secretions were collected from all enrolled patients with CF before and after inhalation of 7% HSS, and the samples were screened for pathogens.
Inhalation of 7% HSS increased the probability of producing sputum from 36 to 52% (p = 0.002) in children with CF. The effect was most in children under 11 years. Inhalation of 7% HSS improved qualitative pathogen identification (p = 0.008). Inhalation of 7% HSS increased the mucoid Pseudomonas aeruginosa (p = 0.002) and non-mucoid P. aeruginosa in the semi-quantitative analysis (p = 0.035). Four new pathogens (Aspergillus fumigatus, Achromobacter xylosoxidans, Ochrobactrum anthropi, and Elizabethkingia meningoseptica) were identified in the sputum samples collected from the airways of patients with CF following 7% HSS.
Inhalation of 7% HSS increased sputum production and pathogen identification in children with CF. The inhalation of 7% HSS was feasible and should be implemented for routine pathogen detection in the airways of patients with CF, particularly in those patients who do not produce sputum.
本研究旨在比较囊性纤维化（CF）患者气道分泌物中病原体的定性和半定量检测，以及吸入 7%高渗盐水（HSS）前后的痰液诱导能力。
本研究纳入了 64 例 CF 患者。所有 CF 患者均在吸入 7%HSS 前后采集气道分泌物，并对样本进行病原体筛查。
吸入 7%HSS 使 CF 患儿产生痰液的概率从 36%增加到 52%（p=0.002）。该效果在 11 岁以下儿童中最为显著。吸入 7%HSS 改善了定性病原体识别（p=0.008）。吸入 7%HSS 增加了半定量分析中的黏液性铜绿假单胞菌（p=0.002）和非黏液性铜绿假单胞菌（p=0.035）。在 CF 患者气道采集的痰液样本中，通过吸入 7%HSS 鉴定出了 4 种新的病原体（烟曲霉、木糖氧化无色杆菌、恶臭假单胞菌和脑膜脓毒性伊丽莎白菌）。
吸入 7%HSS 增加了 CF 患儿的痰液生成和病原体鉴定。吸入 7%HSS 是可行的，应在 CF 患者气道进行常规病原体检测中实施，特别是对于那些不产生痰液的患者。
