Induced sputum in baby (with additional comment)

Question

Dear expert team,
my daughter (7 weeks old) has been diagnosed to suffer from CF because of a positive newborn screening. She has no symptoms until now. In the coming week, further diagnostic is done and the beginning of a therapy during a stay on the ward. I have been told, that every 4 weeks an induced sputum has to be gained for microbiological investigation.
My question is: is it really necessary in such a young child to have this quite stressing investigation done every 4 weeks? Would greater time intervals respecitvely the performance of throat swabs lead to a worsening of the prognosis ?
Thank you!
V.S.

Answer

Hello!
Openly speaking, we are treating many screened children with CF. However I did not know until now, that one can gain reliably induced sputum in such a young child. We are only performing throat swabs in children, even if we know, that the meaning is only limited. I am not sure, if the CF center is really speaking about induced sputum, like we think about it. Babies cannot produce sputum. The sole thing, that I could imagine, would be to provoke cough with hypertonic NaCl and do a throat swab afterwards. However, this is not an induced sputum. Therefore, please ask again, if the collegues did really mean it like this.
Best regards,
Olaf Sommerburg

04.06.2015

02.04.2015: Feedback from the questioner to the above answer:

“Dear Dr. Sommerburg,
Many thanks for answering my question – it really deals with an induced sputum for the baby (at least our CF center names it like this)- At first NaCl solution is inhaled and then, if the baby starts coughing, the sputum is sucked off. It was luckily less bad for my daughter than thought before and after she has already had much of Staphylococcus aureus in her secretions and we are already doing an antibiotic therapy, my question has already relativized. Many thanks for this website!
Best regards, "

07.04.15 Comment from Dr. Sommerburg:
„Yes, that sounds like a good method, to gain sputum from „deeper“ regions oft he lung in a baby with CF. I was not aware of the fact, that some CF centers are doing this quite complicated procedure, to get a picture of germ colonization this way. It would therefore interesting to know, in how far the “gain” of germs differes from those centers (like us), who are taking throat swabs from babies after inhaling hypertonic NaCl. However until now I could not image, that non-symptomatic babies with CF produce such great amounts of secretions even after inhalation with hypertonic NaCl, that one is able to suck it off.
I wish you and your child all the best,
Best regards,
Olaf Sommerburg"