Section of Pediatric Pulmonary and Sleep Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Breathing Institute, Children's Hospital Colorado, Aurora, Colorado, USA.
Pediatr Pulmonol. 2021 Jul;56(7):2043-2047. doi: 10.1002/ppul.25421. Epub 2021 Apr 26.
Collection of respiratory cultures for airway microbiology surveillance is an essential component of routine clinical care in cystic fibrosis (CF). The COVID-19 global pandemic has necessitated increased use of telehealth, but one limitation of telehealth is the inability to collect respiratory specimens. We initiated a protocol for at-home collection of oropharyngeal (OP) swabs from children with CF.
Home respiratory specimen collection was offered during telehealth encounters. Home OP swab kits were sent to participating families via mail with instructions for collection and return. Specimens were returned by overnight shipping or dropped off at a hospital lab for processing and culture. We evaluated demographic data and compared culture results from the home-collected specimen to the most recent specimen collected in clinic. We also tracked the frequency of newly identified Pseudomonas aeruginosa.
Home OP swab kits were sent to families of 33 children with CF (range 1.5-19 years). OP swab kits were successfully returned from 19 children (range 1.5-19 years). One or more CF pathogens grew from 79% of the specimens. For four individuals, the home collected specimen demonstrated the new growth of P. aeruginosa.
Home collection of OP swabs for bacterial culture is feasible in children with CF across a range of ages. Most home-collected specimens demonstrated growth of one or more CF pathogens and results were similar to recent in-clinic specimens, suggesting acceptable sample collection technique. Anti-pseudomonal therapy was initiated for four children based on the growth of P. aeruginosa from the home respiratory specimen.
收集呼吸道培养物进行气道微生物监测是囊性纤维化 (CF) 常规临床护理的重要组成部分。COVID-19 全球大流行使得远程医疗的使用增加，但远程医疗的一个限制是无法收集呼吸道标本。我们开始制定一项从 CF 患儿家中采集口咽 (OP) 拭子的方案。
在远程医疗就诊期间提供家庭呼吸标本采集。家庭 OP 拭子套件通过邮件寄送给参与的家庭，并附有采集和返还说明。标本通过隔夜快递或送到医院实验室进行处理和培养。我们评估了人口统计学数据，并比较了从家庭采集的标本与最近在诊所采集的标本的培养结果。我们还跟踪了新鉴定的铜绿假单胞菌的频率。
家庭 OP 拭子套件寄给了 33 名 CF 患儿的家庭（年龄范围 1.5-19 岁）。OP 拭子套件成功从 19 名儿童（年龄范围 1.5-19 岁）中返回。79%的标本中至少有一种 CF 病原体生长。对于 4 个人，家庭采集的标本显示新长出铜绿假单胞菌。
在年龄范围广泛的 CF 儿童中，家庭采集 OP 拭子进行细菌培养是可行的。大多数家庭采集的标本显示出一种或多种 CF 病原体的生长，结果与最近的门诊标本相似，表明采集技术可接受。根据家庭呼吸道标本中铜绿假单胞菌的生长，对 4 名儿童开始使用抗假单胞菌治疗。
