Throat swab, how often????

Question

I asked the doctor of our outpatient clinic if it is possible to have a throat swab done every 4 – 6 weeks instead of every 3 months. She is of the opinion that one would end up driving himself/herself crazy [if the test was done too often; remark of translator] and that if the child had no symptoms one could assume that there was no pseudomonas infection. Are you of the same opinion or does it make sense to do the swab after shorter periods in order be able to take measures even before the first symptoms occur?
Thank you for your answer.

Answer

Hello,

the diagnosis of a pseudomonas infection in small children is done by a (microbiological) testing of the throat swab, later by a sputum test. For the reliability of the diagnosis the frequency of the testing is important; that means: for the statement “pseudomonas negative” it is important to know, how many test results were negative. For children who do not produce sputum yet and who are supposed to have no infection, the recommendation is as follows: at least 8 throat swabs per year in separate months. For children who already produce sputum, the sputum test should be done 4-6 times a year. In this context it can also be of help to determine the pseudomonas antibodies in the blood.

A pseudomonas colonisation can occur very early; and signs for inflammation can also be determined in the lung very early, even before first clinical symptoms of the disease appear like e.g. cough. Unfortunately, for CF there is no easy and non-invasive test for the evidence of a relatively healthy lung without bacteria colonisation. Currently, frequent throat swabs are a very effective and well tolerated method for children to detect a pseudomonas infection at an early stage.

Best regards,
Dr. H. Ellemunter

20.10.2009