Cystic Fibrosis Clinical Trial
Official title:
Diagnostic Utility of Induced Sputum Using Hypertonic Saline to Evaluate Airway Infection and Inflammation in Cystic Fibrosis
The objective of the study is to evaluate the clinical utility and the feasibility, in an outpatient setting, of sputum induction using hypertonic saline. This study will also study pilot techniques on a sub using a sub-sample to assess the lower airway inflammatory cells and markers in relation to new emerging organisms in cystic fibrosis (CF) and antibiotic therapy in CF.
Chronic airway infection, mainly by Staphylococcus aureus (SA) and Pseudomonas aeruginosa
(PA), is a major cause of morbidity and mortality in patients with cystic fibrosis (CF).
Isolation of organisms from the respiratory tract is important to optimize treatment. The
current recommended methods for bacterial evaluation are bronchoalveolar lavage (BAL) and
expectorated sputum (ES) analysis. However, a significant proportion of young CF patients
cannot produce sputum spontaneously. The method used most frequently therefore is to isolate
respiratory organisms is to perform throat swabs (TS) which have poor sensitivity and
specificity in the evaluation of respiratory pathogens in CF patients.
Induced sputum (IS) using hypertonic saline has been used in a limited number of studies to
evaluate respiratory organisms in CF patients. These studies have reported that IS may be a
useful non-invasive diagnostic test to increase the yield of detection of respiratory
pathogens.
Beside its use as a diagnostic test to identify bacterial pathogens induced sputum has been
used to assess lower airway inflammation in CF. While numerous studies have clarified the
role of S. aureus and P. aeruginosa in CF lung disease, the role of other emerging bacteria
such as Stenotrophomonas maltophilia (SM) and Achromobacter xylosoxidans (AX) species
remains largely unclear. IS offers the potential to possibly differentiate between
colonisation and infection for the emerging pathogens and to help clarify their role in CF
lung disease.
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Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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