Chest physiotherapy enhances detection of in nonexpectorating children with cystic fibrosis.
Fiche publication
Date publication
janvier 2021
Journal
ERJ open research
Auteurs
Membres identifiés du Cancéropôle Est :
Pr ABELY Michel, Pr HUET Frédéric
Tous les auteurs :
Marguet C, Houdouin V, Pin I, Reix P, Huet F, Mittaine M, Ramel S, Wizla-Derambure N, Abely M, Dalphin ML, Fayon M, Bihouée T, Le Bourgeois M, Deneuville E, Corvol H, Laurans M, Couderc L, Leroux E, Lémée L
Lien Pubmed
Résumé
Lung damage in cystic fibrosis (CF) is strongly associated with lower airway infections. Early treatment of is recommended. Pathogen detection requires sampling of lower airway secretions, which remains a challenge in nonexpectorating patients. Our hypothesis was that chest physiotherapy would improve the quality of airway secretion samples and increase the rates of pathogens detected in nonexpectorating patients. This prospective multicentre study compared three successive methods for sampling airway secretions applied through the same session: 1) an oropharyngeal swab (OP), 2) a chest physiotherapy session followed by a provoked cough to obtain sputum (CP-SP) and 3) a second oropharyngeal swab collected after chest physiotherapy (CP-OP). , and growth cultures were assessed. Accuracy tests and an equivalence test were performed to compare the three successive methods of collection. 300 nonexpectorating children with CF were included. was detected cumulatively in 56 (18.9%) children, and according to the different collection methods in 28 (9.8%), 37 (12.4%) and 44 (14.7%) children by using OP, CP-OP and CP-SP, respectively. Compared with OP, the increased detection rate was +22% for CP-OP (p=0.029) and +57% for CP-SP (p=0.003). CP-SP had the best positive predictive value (86.3%) and negative predictive value (96.0%) for compared with the overall detection. The results of this adequately powered study show differences in the rates of pathogens detected according to the sampling method used. Chest physiotherapy enhanced detection of in nonexpectorating children with CF.
Référence
ERJ Open Res. 2021 Jan;7(1):