Pseudomonas detection

Question

Hello,

The serology for Pseudomonas (antibodies)- has it an interest and is it reliable to detect Pseudomonas aeruginosa when sputum cultures are negative or impractical because the child is not expectorating secretions (chronic colonization in the past with no Pseudomonas actually)?

What would be the alternatives in terms of exams?

thanks in advance
cordially

Answer

Hello,

Data from some groups showed the potential interest of the realization of Pseudomonas aeruginosa serology (antibodies) in terms of chronicity prediction.

By cons, there is only one study (Daines C et al. J Cystic Fibrosis 2014) on the value of serology in non-expectorating children to assess its ability to predict the occurrence of primary colonisation by Pseudomonas aeruginosa. In this study, it appears that overlap of results between the "control" groups (that is to say non-affected children) and groups of CF children who are going to be colonized or not by PA are such that the interest of the antibody assay appears limited.

The current technique for analyzing the microbial flora (oropharyngeal swab) remains the gold standard. It can be optimized, although this is not officially recommended, by the usage of a hypertonic saline spray prior. The completion of sampling by bronchoscopy is not recommended routinely, that is to say outside of the justification by clinical situation. This approach has also not proved its superiority in terms of Pseudomonas aeruginosa detection in relation to the realization of a pharyngal oral-swab (ACFBAL study) (C Wainwright et al. JAMA. 2011).

Best regards,
Dr Philippe Reix

16.07.2016