Acute Pain Perception During Different Sampling Methods for Respiratory Culture in Cystic Fibrosis Patients

Eyns, H.; Wachter, Elke De; Malfroot, Anne; Vaes, Peter

doi:10.1016/j.jpainsymman.2017.11.004

Cited by 2 publications

(5 citation statements)

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“…Nonetheless, in symptomatic patients, sputum induction should be performed prior to BAL (12). Additionally, despite the fact that our non-expectorating patients preferred the nasal swab as sampling method (34), we will not use nasal swab as sampling method because our results demonstrated that it was not appropriate to detect pathogens of the lower airways. Likewise, we will obtain spontaneously expectorated sputum from patients who are able to expectorate, because of the overall significant superiority compared to cough swab.…”

Section: Discussionmentioning

confidence: 98%

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Respiratory Bacterial Culture Sampling in Expectorating and Non-expectorating Patients With Cystic Fibrosis

et al. 2018

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Purpose: Different respiratory sampling methods exist to identify lower airway pathogens in patients with cystic fibrosis (CF), of which bronchoalveolar lavage (BAL), and expectorated sputum are considered the “gold standard.” Because BAL cannot be repeated limitless, the diagnosis of lower respiratory tract infections in non-expectorating patients is challenging. Other sampling techniques are nasal swab, cough swab, and induced sputum. The purpose of this study (NCT02363764) was to compare concordance between the microbiological yield of nasal swab, cough swab, and expectorated sputum in expectorating patients; nasal swab, cough swab, and induced sputum in non-expectorating patients; nasal swab, cough swab, induced sputum, and BAL in patients requiring bronchoscopy (“BAL-group”); and to determine the clinical value of cough swab in non-expectorating patients with CF.Methods: Microbiological yield detected by these different sampling techniques was compared between and within 105 expectorating patients, 30 non-expectorating patients and BAL-group (n = 39) in a single CF clinic. Specificity, sensitivity, positive (PPV), and negative (NPV) predictive values were calculated.Results: Overall low sensitivity (6.3–58.0%) and wide-ranging predictive values (0.0–100.0%) indicated that nasal swab was not appropriate to detect lower airway pathogens [Pseudomonas aeruginosa (Pa), Staphylococcus aureus (Sa), and Haemophilus influenzae (Hi)] in all three patient groups. Microbiological yield, specificity, sensitivity, PPV, and NPV of cough swab and induced sputum were largely similar in non-expectorating patients and in BAL-group (except sensitivity (0.0%) of induced sputum for Hi in BAL-group). Calculations for Pa and Hi could not be performed for non-expectorating patients because of low prevalence (n = 2 and n = 3, respectively). In expectorating patients, concordance was found between cough swab and expectorated sputum, except for Hi (sensitivity of 40.0%).Conclusion: Our findings suggest that cough swab might be helpful in detecting the presence of some typical CF pathogens in the lower airways of clinically stable patients with CF. However, in symptomatic patients, who are unable to expectorate and who have a negative cough swab and induced sample, BAL should be performed as it currently remains the “gold standard.”

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Section: Discussionmentioning

confidence: 98%

“…Likewise, we will obtain spontaneously expectorated sputum from patients who are able to expectorate, because of the overall significant superiority compared to cough swab. In addition, this sampling technique was preferred over cough swab and nasal swab in expectorating patients (34).…”

Section: Discussionmentioning

confidence: 99%

Respiratory Bacterial Culture Sampling in Expectorating and Non-expectorating Patients With Cystic Fibrosis

et al. 2018

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“…5 Furthermore, Eyns et al suggested possible factors that make throat swabs more painful: (1) the extent of direct contact the swab makes with the pharyngeal wall and (2) induction of a gag reflex. 5 A study focussing on pain symptoms in children with CF found that most children reported mild pain for CF-related procedures whilst a small number reported severe pain, 8% of which were due to throat cultures. 6 In the complete clinic cohort in our study, more than a third of children aged 4−12 years reported moderate to severe anxiety and a quarter had moderate to severe pain related to throat swab collection.…”

Section: Discussionmentioning

confidence: 99%

“…Throat swabs are an important part of disease surveillance in children who are unable to produce sputum. Throat swabs have been previously described as the worst thing performed in CF clinics, with some patients having developed a phobia towards the procedure 5 . Furthermore, Eyns et al suggested possible factors that make throat swabs more painful: (1) the extent of direct contact the swab makes with the pharyngeal wall and (2) induction of a gag reflex 5 .…”

Section: Discussionmentioning

confidence: 99%

“…Throat swabs have been previously described as the worst thing performed in CF clinics, with some patients having developed a phobia towards the procedure 5 . Furthermore, Eyns et al suggested possible factors that make throat swabs more painful: (1) the extent of direct contact the swab makes with the pharyngeal wall and (2) induction of a gag reflex 5 . A study focussing on pain symptoms in children with CF found that most children reported mild pain for CF‐related procedures whilst a small number reported severe pain, 8% of which were due to throat cultures 6 .…”

Section: Discussionmentioning

confidence: 99%

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High rates of procedure‐related pain and anxiety in children with cystic fibrosis

Wang

Armstrong

Nixon

2023

Pediatric Pulmonology

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Acute Pain Perception During Different Sampling Methods for Respiratory Culture in Cystic Fibrosis Patients

Cited by 2 publications

References 29 publications

Respiratory Bacterial Culture Sampling in Expectorating and Non-expectorating Patients With Cystic Fibrosis

Respiratory Bacterial Culture Sampling in Expectorating and Non-expectorating Patients With Cystic Fibrosis

High rates of procedure‐related pain and anxiety in children with cystic fibrosis

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