Sputum Cytology Examination (SCE)

Question

Hello,

My little son, aged 5, had no sputum culture for several months. Indeed, during the last 3 controls in his CF center, no sample of sputum was possible (nothing back).

If during the next visit no sample can be obtained, what is going to happen?
How do we know that there is no colonization without SCE?

The situation does not seem to worry carers ... which is different for me.

Thank you in advance for your answer.

Answer

Hello.

Regular monitoring of sputum culture (at least 4 samples per year) is part of the recommendations for the management of cystic fibrosis patients, including patients (mostly young) non-secretory (or "non-eaters"). In this case, the caregiver (usually a physiotherapist) can perform a throat swab (kind of big "Q-tip) after a bronchial drainage session (this increases the chances of collecting a representative sample of germs present in the lower airways). Maybe your little son has benefited from this type of sampling? Swabbing provides a more accurate picture of these germs, but it is less sensitive than the direct analysis of secretions/sputum for germs such as Pseudomonas aeruginosa. In some situations, techniques that promote the production of secretions may be added (inhalation of hypertonic saline aerosol). But it significantly extends the duration of the session, reducing the feasibility and the repetition of this type of technique. As a last resort, but it is currently not recommended when the child is well, bacteriological samples can be gainde during a bronchoscopy.

Best Regards.
Prof. Philippe REIX

12.02.2015