Cultures of thoracotomy specimens confirm usefulness of sputum cultures in cystic fibrosis

Thomassen, Mary Jane; Klinger, Jeffrey D.; Badger, S J; Heeckeren, Daniel W. van; Stern, Robert C.

doi:10.1016/s0022-3476(84)81094-x

Cited by 93 publications

(41 citation statements)

References 13 publications

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“…The importance of anaerobes in other types of pulmonary infection in children is well recognised, especially in the USA (Bartlett and Finegold, 1974;Brook and Finegold, 1980). In the present study, the number of anaerobes in the sputum of C F patients was measured by use of a semi-quantitative method, similar to that described by Thomassen et al (1984). Received 28 Nov. 1988;revised version accepted 24 Oct. 1989.…”

Section: Introductionmentioning

confidence: 89%

“…Brook and Fink (1 983) and Thomassen et al (1984) reported the isolation of anaerobes from transtracheal and thoracotomy specimens (lung biopsies and parenchymal aspirates) from C F patients. The importance of anaerobes in other types of pulmonary infection in children is well recognised, especially in the USA (Bartlett and Finegold, 1974;Brook and Finegold, 1980).…”

Section: Introductionmentioning

confidence: 99%

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The incidence of anaerobes in the sputum of patients with cystic fibrosis

Jewes

Spencer²

1990

Journal of Medical Microbiology

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Summary. The number of anaerobes in selected sputum samples from patients with cystic fibrosis (CF) was investigated. When cultured by a semi-quantitative method, 26 (23.85%) of 109 sputum specimens from 21 C F patients contained > lo5 cfu of anaerobic organisms/ml. Nine (42.7%) of the 21 patients produced sputum containing such concentrations of anaerobes on at least one occasion. Anaerobes were isolated from repeated sputum specimens from five patients. The anaerobes most often isolated were Bacteroides disiens, pigmented Bacteroides spp. and anaerobic grampositive cocci. Anaerobes were isolated more often from sputum liquefied by sonication than from unliquefied sputum, suggesting that they were unlikely to be oropharyngeal contaminants.

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Section: Introductionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

The incidence of anaerobes in the sputum of patients with cystic fibrosis

Jewes

Spencer²

1990

Journal of Medical Microbiology

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“…A culture from the lower airway secretions is necessary to guide antimicrobial therapy. Sputum cultures are considered a valuable substitute for a lower airway sample obtained by bronchoscopy or thoracotomy, since results from both sites will correspond in over 70% of cases [3].Many young CF patients do not produce sputum. Since oropharyngeal cultures have only a poor positive predictive value [4,5], bronchoalveolar lavage (BAL) remains the standard technique to obtain a lower airway sample in these patients.…”

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confidence: 99%

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confidence: 99%

Sputum induction in young cystic fibrosis patients

Boeck¹,

Alifier²,

Vandeputte³

2000

Eur Respir J

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A culture from the lower airway secretions is the optimal sample to guide antibiotic therapy in cystic fibrosis (CF) lung disease. The authors therefore examined whether sputum induction is an efficient, safe and acceptable procedure in CF children without spontaneous expectorations.Nineteen patients were studied. Their mean age (range) was 8.6 yrs (4.3±15.2 yrs). Their mean forced expiratory volume in one second (FEV1) was 88% predicted (46± 122%). NaCl solutions from 0.9±6% were inhaled, after baseline lung function tests before and after salbutamol.All patients did produce secretions. Alveolar macrophages were present in 16/19 induced samples. The procedure induced minor but significant bronchoconstriction: the mean change (range) in postsalbutamol FEV1 (% pred) was -7 (-24±16). Percutaneous oxygen saturation remained above 90% in all children. The test had to be discontinued in one child because of cough and wheeze. Acceptability of the procedure evaluated using a visual analogue scale from -7±7 showed a mean value (range) at the final concentration of -1.23 (-6.16±5.88).It is concluded that sputum induction is possible, safe and acceptable in cystic fibrosis children who do not expectorate spontaneously. Chronic lower respiratory tract infection is the predominant manifestation of cystic fibrosis (CF). In young CF patients it is important to recognize and treat lung infection as early as possible, since with correct treatment Pseudomonas aeruginosa colonization can be avoided or delayed [1,2]. A culture from the lower airway secretions is necessary to guide antimicrobial therapy. Sputum cultures are considered a valuable substitute for a lower airway sample obtained by bronchoscopy or thoracotomy, since results from both sites will correspond in over 70% of cases [3].Many young CF patients do not produce sputum. Since oropharyngeal cultures have only a poor positive predictive value [4,5], bronchoalveolar lavage (BAL) remains the standard technique to obtain a lower airway sample in these patients. It is, however, an expensive, time consuming, unpleasant and potentially harmful procedure.Recently, in patients infected with Pneumocystis carinii and Mycobacteria [6±8], sputum induction during hypertonic saline inhalation was proven to provide information comparable to that obtained by bronchoscopy and BAL. Similarly, cytological evaluation of induced sputum is considered helpful in patients with asthma and lung malignancies [9±11]. Sputum induction using hypertonic saline is efficacious in >90% of adult asthmatics [12]. Although the drop in postsalbutamol forced expiratory volume in one second (FEV1) after inhalation was larger in asthmatics than in normals a fall exceeding 20% only occurred in 3/37 patients. Sputum induction using hypertonic saline is also efficacious and safe in adolescent asthmatics [13,14] and isotonic saline sputum induction appears to be safe in children with acute asthma [15]. Although the feasibility of sputum induction has been reported in patients with CF [16], a systemati...

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“…It is noteworthy, however, that in CF the presence of Pseudomonas in the sputum was found to correlate well with bronchial secretions and lung tissue. 16,17 The use of bronchial lavage and protected catheter would have been likely to give more accurate information, but not without risks in these patients who were acutely ill, with a compromised lung function. Thus, studies that used this technique, such as the Hong Kong study, 5 were limited by a small number of patients who were in a stable clinical state.…”

Section: Discussionmentioning

confidence: 99%

Pseudomonas Aeruginosa in Hospitalized Patients with Infective Exacerbations of Bronchiectasis: Clinical and Research Implications

et al. 1998

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A Al-Mobeireek, A-M Kambal, SR Al-Balla, H Al-Sawwaf, S Saleemi, Pseudomonas Aeruginosa in Hospitalized Patients with Infective Exacerbations of Bronchiectasis: Clinical and Research Implications. 1998; 18(5): 469-471 Bronchiectasis is becoming less of a problem in developed countries since the advent of antibiotics and the implementation of immunization programs.1,2 It is still, however, a significant cause of illness in developing countries. To our knowledge, there are no statistics on the prevalence of bronchiectasis in Saudi Arabia. Nonetheless, many chest physicians would agree that patients with this disease are seen frequently, both in the outpatient and the inpatient settings.Acute infective exacerbations related to bacterial pathogens are common and remain an important cause of morbidity and mortality in bronchiectasis. Even in the "stable" status between these exacerbations, it is believed that these organisms contribute to the perpetuation of the chronic inflammatory process and progressive lung damage. Identification and appropriate treatment of these pathogens is an essential part of the management.2 The objective of this study was to determine the range and sensitivity of bacterial pathogens that are isolated from the respiratory secretions of patients admitted with infective exacerbations of bronchiectasis. Findings are compared with other studies, and the significance of bacterial isolates, particularly Pseudomonas aeruginosa, is discussed. Patients and MethodsThe study was conducted prospectively at King Khalid University Hospital (KKUH) and Sahary Chest Hospital in Riyadh, during the years 1994-1995. Both health institutions function as general and tertiary referral hospitals, serving the Central Province (Najd), but also at times accepting patients from other parts of the Kingdom.All patients had bronchiectasis, defined by a history of chronic productive cough and an abnormal permanent dilatation of one or more bronchi on plain film or computed tomography. These patients were admitted to one of the above hospitals through the emergency department on the basis of features that were compatible with infective exacerbations. For the purpose of this study, an infective exacerbation was defined as an increase in sputum quantity, or a change in the character of the sputum from mucoid to purulent. Patients were questioned about cough, sputum (quantity, color), hemoptysis, dyspnea, fever, the chronicity of these symptoms, any recent change, any preceding flu-like illness suggesting an upper respiratory tract infection (URTI), and the use of antibiotics within one month before admission. None of the patients had clinical features of cystic fibrosis (CF), and all patients under 20 years of age underwent sweat chloride tests.Sputum samples were collected in sterile bottles and sent to the Microbiology Laboratory at KKUH and processed within one to two hours, or were kept at 4°C until processing. Gram staining was done by selecting a purulent portion of the specimen and spreading it on a microscopic sli...

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Cultures of thoracotomy specimens confirm usefulness of sputum cultures in cystic fibrosis

Cited by 93 publications

References 13 publications

The incidence of anaerobes in the sputum of patients with cystic fibrosis

The incidence of anaerobes in the sputum of patients with cystic fibrosis

Sputum induction in young cystic fibrosis patients

Pseudomonas Aeruginosa in Hospitalized Patients with Infective Exacerbations of Bronchiectasis: Clinical and Research Implications

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