Abstract
The use of sputum cultures to guide the antimicrobial treatment of patients with cystic fibrosis has been questioned. Bacterial growth and antibiotic susceptibility patterns of 33 culture pairs from sputum and contamination free endobronchial swabs from 14 patients with cystic fibrosis were compared. As expected, Pseudomonas aeruginosa of the mucoid and non-mucoid type, Staphylococcus aureus, and Haemophilus influenzae were the organisms most frequently found. Absolute or good agreement was found in 73% of the culture pairs. The accuracy of the sputum cultures improved with the duration of antimicrobial treatment. The extra information gained from the endobronchial culture did not change the antimicrobial strategy from that based on the sputum culture alone. It is concluded that sputum cultures provide accurate information about the bacterial colonisation of the lower respiratory tract in patients with cystic fibrosis and therefore can be trusted both at onset of treatment and during the entire treatment period.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Baran D., Cordier N. Usefulness of transtracheal puncture in the bacteriological diagnosis of lung infections in children. Helv Paediatr Acta. 1973 Nov;28(5):391–399. [PubMed] [Google Scholar]
- Bartlett J. G., Finegold S. M. Bacteriology of expectorated sputum with quantitative culture and wash technique compared to transtracheal aspirates. Am Rev Respir Dis. 1978 Jun;117(6):1019–1027. doi: 10.1164/arrd.1978.117.6.1019. [DOI] [PubMed] [Google Scholar]
- Beaudry P. H., Marks M. I., McDougall D., Desmond K., Rangel R. Is anti-Pseudomonas therapy warranted in acute respiratory exacerbations in children with cystic fibrosis? J Pediatr. 1980 Jul;97(1):144–147. doi: 10.1016/s0022-3476(80)80155-7. [DOI] [PubMed] [Google Scholar]
- Elliott R. B., Crossley J. R., Berryman C. C., James A. G. Partial preservation of pancreatic beta-cell function in children with diabetes. Lancet. 1981 Jul 4;2(8236):1–4. doi: 10.1016/s0140-6736(81)90249-x. [DOI] [PubMed] [Google Scholar]
- Kalin M., Lindberg A. A., Tunevall G. Etiological diagnosis of bacterial pneumonia by gram stain and quantitative culture of expectorates. Leukocytes or alveolar macrophages as indicators of sample representativity. Scand J Infect Dis. 1983;15(2):153–160. doi: 10.3109/inf.1983.15.issue-2.05. [DOI] [PubMed] [Google Scholar]
- Roberts D. E., Cole P. Use of selective media in bacteriological investigation of patients with chronic suppurative respiratory infection. Lancet. 1980 Apr 12;1(8172):796–797. doi: 10.1016/s0140-6736(80)91295-7. [DOI] [PubMed] [Google Scholar]
- SHWACHMAN H., KULCZYCKI L. L. Long-term study of one hundred five patients with cystic fibrosis; studies made over a five- to fourteen-year period. AMA J Dis Child. 1958 Jul;96(1):6–15. doi: 10.1001/archpedi.1958.02060060008002. [DOI] [PubMed] [Google Scholar]
- Strandvik B., Malmborg A. S., Alfredson H., Ericsson A. Clinical results and pharmacokinetics of ceftazidime treatment in patients with cystic fibrosis. J Antimicrob Chemother. 1983 Jul;12 (Suppl A):283–287. doi: 10.1093/jac/12.suppl_a.283. [DOI] [PubMed] [Google Scholar]
- Thomassen M. J., Demko C. A., Boxerbaum B., Stern R. C., Kuchenbrod P. J. Multiple of isolates of Pseudomonas aeruginosa with differing antimicrobial susceptibility patterns from patients with cystic fibrosis. J Infect Dis. 1979 Dec;140(6):873–880. doi: 10.1093/infdis/140.6.873. [DOI] [PubMed] [Google Scholar]
- Thomassen M. J., Klinger J. D., Badger S. J., van Heeckeren D. W., Stern R. C. Cultures of thoracotomy specimens confirm usefulness of sputum cultures in cystic fibrosis. J Pediatr. 1984 Mar;104(3):352–356. doi: 10.1016/s0022-3476(84)81094-x. [DOI] [PubMed] [Google Scholar]