76 Identification of Pseudomonas aeruginosa infection in a paediatric CF population

Abstract

Objective To analyse the importance of obtaining regular sputum samples in identifying P. aeruginosa infection in a paediatric cystic fibrosis (CF) population. Royal Manchester Children's Hospital provides care to 182 children with CF. Sputum and/or cough swab samples are taken at each clinic visit. Our local practice is to encourage families to also send sputum samples/ cough swabs to us twice a month. Methods Analysis of cough swab and sputum samples of all our CF patients during a 2-year period (October 2012 to September 2014). Children were classified according to the Leeds criteria for P. aeruginosa infection, with an additional category of Results 5973 samples were obtained over the 2-year period from our CF population. Table 1P. aeruginosa statusNumber of children (total = 182)Never infected61 (33%)Free of infection67 (37%)Intermittent infection29 (16%)Chronic infection18 (10%)First growth7 (4%) We then analysed P. aeruginosa status if only samples taken at clinic were used. Table 2. Table 2P. aeruginosa statusNumber of childrenAll samplesClinic samples onlyIntermittent infection2914First growth74 If clinic samples alone were analysed, we would have identified 14/29 children with intermittent infection and 4/7 children with first growth. Conclusion Potentially significant pathogens may not be identified if sputum/cough swab samples are only obtained at clinic visits. In our CF population, 18 children (10%) with P. aeruginosa growth would not have been identified if samples had only been taken at clinic.