systematic sputum / cough swab culture

Question

Hello,
The CF centre of my daughter does not practice cough swab systematically at each visit. We are afraid of missing out a bacterium that could worsen the health of our daughter. We are in February and the last culture was done in September. Can I ask them to do it consistently? Can a local laboratory do the cough swab culture?
Cordially.

Answer

Hello,
You do not specify if your daughter has cystic fibrosis and if it is typical or atypical.
You ask about the risk to miss a bronchial bacterial colonization that may aggravate her condition, in the absence of systematic sampling.
Your question is relevant because there are actually cases of asymptomatic bronchial colonization itself, i.e. without signs such as cough, shortness of breath or slow weight gain are evident.
For these reasons, it is recommended that patients with cystic fibrosis typically are seen regularly in the CF centre (every month until the age of 6 months and then at least every 2 months up to 1 year, every 2 to 3 months after the age of 1 year with a minimum of four annual visits for systematic typical forms of children and adults).
At each visit an airway sample culture should be performed on sputum or throat swab when the patient is not secreting.
It is not advisable to carry out the sputum culture in a local laboratory, because the analysis is specific for cystic fibrosis and requires a specialized laboratory most often attached to the CF centre. Some germs are not easily identified outside of a reference center.
I encourage you to discuss this with your CF team.
Sincerely,
Dr Sophie Ravilly

04.03.2013