TY - JOUR T1 - The clinical significance of oropharyngeal cultures in young children with cystic fibrosis JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00238-2018 SP - 1800238 AU - Oded Breuer AU - Daan Caudri AU - Lauren Akesson AU - Sarath Ranganathan AU - Stephen M Stick AU - André Schultz A2 - , Y1 - 2018/01/01 UR - http://erj.ersjournals.com/content/early/2018/04/05/13993003.00238-2018.abstract N2 - In children with cystic fibrosis (CF) the associations between oropharyngeal swabs (OPS) for detection of Pseudomonas and lung disease has not been evaluated.OPS and bronchoalveolar lavage (BAL) samples were obtained annually in children with CF from 2005 to 2017. OPS test characteristics were calculated using BAL as gold standard. Results were related to lung inflammation (BAL neutrophil elastase, interleukin-8), structural lung disease (chest CT PRAGMA-CF scores), respiratory exacerbations, and future detection of Pseudomonas on BAL.From 181 patients, 690 paired OPS-BAL cultures were obtained. Prevalence of Pseudomonas in BAL was 7.4%. OPS sensitivity was 23.0% and specificity 91.4%, reducing the post-test probability for a positive BAL following a negative OPS to 6.3%. Pseudomonas on OPS was not associated with lung inflammation or respiratory exacerbations but was weakly associated with current PRAGMA-CF %disease score (p=0.043). Pseudomonas on BAL was associated with positive neutrophil elastase (OR 4.17 CI95% 2.04–8.53, p<0.001), increased interleukin-8 (p<0.001), increased all baseline PRAGMA-CF scores (p<0.001), progression of PRAGMA-CF scores (p<0.05) and increased risk of respiratory exacerbations (IRR 2.11 CI95% 1.15–3.87, p=0.017).In children with CF OPS only marginally change the probability of detecting lower airway Pseudomonas and are not associated with lung disease indices nor exacerbations risk.Oropharyngeal swab cultures in children with cystic fibrosis are not helpful for ruling out lower airway Pseudomonas infection and are not associated with structural lung disease, lung inflammation or admissions for respiratory exacerbations.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Breuer has nothing to disclose.Conflict of interest: Dr. Caudri has nothing to disclose.Conflict of interest: Dr. Akesson has nothing to disclose.Conflict of interest: Dr. Ranganathan has nothing to disclose.Conflict of interest: Dr. Stick has nothing to disclose.Conflict of interest: Dr. Schultz has nothing to disclose. ER -