Marco Zampoli1, Komala Pillay2, Henri Carrara3, Heather J Zar4, Brenda Morrow5. 1. 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. Electronic address: m.zampoli@uct.ac.za. 2. Department of Anatomical Pathology, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa. Electronic address: komala.pillay@uct.ac.za. 3. School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa. Electronic address: henri.carrara@gmail.com. 4. Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa. Electronic address: heather.zar@uct.ac.za. 5. 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. Electronic address: brenda.morrow@uct.ac.za.
Abstract
BACKGROUND: 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. METHODS: Sequentially paired OPS followed by IS samples was collected in children <5years of age attending a CF clinic in Cape Town, South Africa. RESULTS: 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. CONCLUSION: Sputum induction is feasible, safe and superior to OPS for detecting CF-associated bacteria in young children with CF.
BACKGROUND: 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. METHODS: Sequentially paired OPS followed by IS samples was collected in children <5years of age attending a CF clinic in Cape Town, South Africa. RESULTS: 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. CONCLUSION: Sputum induction is feasible, safe and superior to OPS for detecting CF-associated bacteria in young children with CF.
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