Identification of new bacterial and fungal pathogens on surveillance bronchoscopy prior to sinus surgery in patients with cystic fibrosis

Kirkby, Stephen; Hayes, Don; Ginn‐Pease, Margaret E.; Gatz, J. David; Wisely, C. Ellis; Lind, Meredith; Elmaraghy, Charles; Ryan‐Wenger, Nancy A.; Sheikh, Shahid

doi:10.1002/ppul.23027

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…As such, we recommend flexible bronchoscopy with BAL in patients, particularly in those with inefficient expectoration. Cultures for mycobacteria, fungus, and quantitative bacteria from at least 2 locations within each lung are recommended . In the event of extended wait‐list time (>6 months) or a significant change in pulmonary status, bronchoscopy should be repeated to monitor for change in respiratory flora.…”

Section: The Evaluation For Lt In Patients With Cfldmentioning

confidence: 99%

“…Cultures for mycobacteria, fungus, and quantitative bacteria from at least 2 locations within each lung are recommended. (36) In the event of extended Controversies in Liver transpLantation | 645 wait-list time (>6 months) or a significant change in pulmonary status, bronchoscopy should be repeated to monitor for change in respiratory flora. Additionally, nasal polyps and chronic sinusitis are common in CF and, if identified, should be immediately treated.…”

Section: Pulmonary and Microbial Considerationsmentioning

confidence: 99%

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A Multidisciplinary Approach to Pretransplant and Posttransplant Management of Cystic Fibrosis–Associated Liver Disease

et al. 2019

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Approximately 5%‐10% of patients with cystic fibrosis (CF) will develop advanced liver disease with portal hypertension, representing the third leading cause of death among patients with CF. Cystic fibrosis with advanced liver disease and portal hypertension (CFLD) represents the most significant risk to patient mortality, second only to pulmonary or lung transplant complications in patients with CF. Currently, there is no medical therapy to treat or reverse CFLD. Liver transplantation (LT) in patients with CFLD with portal hypertension confers a significant survival advantage over those who do not receive LT, although the timing in which to optimize this benefit is unclear. Despite the value and efficacy of LT in selected patients with CFLD, established clinical criteria outlining indications and timing for LT as well as disease‐specific transplant considerations are notably absent. The goal of this comprehensive and multidisciplinary report is to present recommendations on the unique CF‐specific pre‐ and post‐LT management issues clinicians should consider and will face.

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Section: The Evaluation For Lt In Patients With Cfldmentioning

confidence: 99%

Section: Pulmonary and Microbial Considerationsmentioning

confidence: 99%

A Multidisciplinary Approach to Pretransplant and Posttransplant Management of Cystic Fibrosis–Associated Liver Disease

et al. 2019

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“…No difference in new pathogen identification was found when sampling one lobe versus multiple locations. Clinicians should consider performing bronchoscopy at time of scheduled sinus surgery …”

Section: Multi‐system Comorbiditiesmentioning

confidence: 99%

Pediatric Pulmonologyyear in review 2015: Part 4

Savant

McColley

2016

Pediatr Pulmonol.

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Safety of research bronchoscopy with BAL in stable adult patients with cystic fibrosis

et al. 2021

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Data on adverse events from research bronchoscopy with bronchoalveolar lavage (BAL) in patients with cystic fibrosis (CF) is lacking. As research bronchoscopy with BAL is useful for isolation of immune cells and investigation of CF lung microbiome, we sought to investigate the safety of bronchoscopy in adult patients with CF. Between November 2016 and September 2019, we performed research bronchoscopies on CF subjects (32) and control subjects (82). Control subjects were nonsmokers without respiratory disease. CF subjects had mild or moderate obstructive lung disease (FEV1 > 50% predicted) and no evidence of recent CF pulmonary exacerbation. There was no significant difference in the age or sex of each cohort. Neither group experienced life threatening adverse events. The number of adverse events was similar between CF and control subjects. The most common adverse events were sore throat and cough, which occurred at similar frequencies in control and CF subjects. Fever and headache occurred more frequently in CF subjects. However, the majority of fevers were seen in CF subjects with FEV1 values below 65% predicted. We found that CF subjects had similar adverse event profiles following research bronchoscopy compared to healthy subjects. While CF subjects had a higher rate of fevers, this adverse event occurred with greater frequency in CF subjects with lower FEV1. Our data demonstrate that research bronchoscopy with BAL is safe in CF subjects and that safety profile is improved if bronchoscopies are limited to subjects with an FEV1 > 65% predicted.

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Identification of new bacterial and fungal pathogens on surveillance bronchoscopy prior to sinus surgery in patients with cystic fibrosis

Cited by 3 publications

References 29 publications

A Multidisciplinary Approach to Pretransplant and Posttransplant Management of Cystic Fibrosis–Associated Liver Disease

A Multidisciplinary Approach to Pretransplant and Posttransplant Management of Cystic Fibrosis–Associated Liver Disease

Pediatric Pulmonologyyear in review 2015: Part 4

Safety of research bronchoscopy with BAL in stable adult patients with cystic fibrosis

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