sputum sample

Question

Hello,
The physiotherapist of the CF Centre has been unable this morning to obtain some sputa from my 5 months old daughter for microbiological culture. He/she said that her bronchi were not enough infected. I don’t understand. In some CF Centres, each month a sputum sample is obtained from each CF patient, even if they are not “infected”. How physiotherapist can obtain sputum ? What are we looking for with a sputum sample ? Thanks.

Answer

Hello and thanks for your question. You're right, a sputum sample or a throat swab has to be obtained from all patients at all medical visits in all CF Centres. The aim of this recommendation is to detect precociously, even when the patient is symptom-free, the presence of germs and to propose an anti-infectious treatment based on the germ that has been found, on the presence of symptoms and/or on the clinical evolution.
Obtaining sputa is easy in children who have a daily cough with sputum which reflects the important bronchial production of secretions. It's a more critical problem in infants who have less bronchial secretions, except in case of exacerbation. In smaller children or babies, who are not able to cough on demand and especially if they are in a healthy state meaning their bronchi are less inflamed and produce therefore less sputum (this is what your physiotherapist meant by "the bronchi of your daughter were not enough infected"), obtaining sputum is frequently impossible. In that case, a swab culture of the throat can be investigated for germs instead of sputum. Therefore an attempt to obtain a sample for microbiological investigation, either a sputum sample or a cough swab, must be made at each medical visit in the CF Centre.
With my best regards,
Pr Jean-Christophe Dubus

10.05.2011