Cost-effective airway cultures in the cystic fibrosis patient

Ghegan, Mark D.; Wise, Sarah K.; White, David R.; Flume, Patrick A.; Bowman, C. Michael; Virella-Lowell, Isabel; Schlosser, Rodney J.

doi:10.1016/j.amjoto.2008.03.006

« Previous Next »American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 30, Issue 3 , Pages 150-152, May 2009

Cost-effective airway cultures in the cystic fibrosis patient

Poster presentation at the American Rhinological Society Annual Meeting, Washington, DC, September 15, 2007.

Mark D. Ghegan, MD
- Department of Otolaryngology HNS, Medical University of South Carolina (MUSC), Charleston, SC, USA
Sarah K. Wise, MD
- Department of Otolaryngology HNS, Medical University of South Carolina (MUSC), Charleston, SC, USA
David R. White, MD
- Department of Otolaryngology HNS, Medical University of South Carolina (MUSC), Charleston, SC, USA
Patrick A. Flume, MD
- Division of Pulmonary Critical Care Medicine, Department of Medicine, MUSC, Charleston, SC, USA
C. Michael Bowman, MD, PhD
- Division of Pulmonary Medicine, Department of Pediatrics, MUSC, Charleston, SC, USA
Isabel Virella-Lowell, MD
- Division of Pulmonary Medicine, Department of Pediatrics, MUSC, Charleston, SC, USA
Rodney J. Schlosser, MD
- Department of Otolaryngology HNS, Medical University of South Carolina (MUSC), Charleston, SC, USA
- Corresponding author. Department of Otolaryngology- Head and Neck Surgery, 135 Rutledge Avenue, Suite 1130, Charleston, SC 29425, USA. Tel.: +1 843 792 8299; fax: +1 843 792 0546.

Received 28 January 2008 published online 02 October 2008.

Abstract

Background

Cystic fibrosis (CF) patients have a high incidence of multidrug-resistant infections, rendering CF patients a treatment challenge.

Objective

To evaluate culture protocols for CF patients and develop a cost-effective culture regimen that identifies clinically relevant pathogens.

Study design

Retrospective review.

Methods

At the time of endoscopic sinus surgery, CF patients underwent both sinus and bronchial lavage cultures. Medical records from 2002 to 2006 were reviewed.

Results

Twenty-four cases were identified; 12 had complete sets of cultures. Seven of 12 had sinus aerobic bacteria that were also present in bronchial culture. Anaerobic cultures from both sites were all negative (42%) or nondiagnostic (58%). Thirty-three percent of sinus fungal cultures and 91.6% of bronchial fungal cultures were positive. Sinus acid fast bacillus cultures were all negative.

Conclusion

CF culture protocols may be streamlined by eliminating all anaerobic cultures, as well as sinus acid fast bacillus and fungal cultures for a 52% reduction in cost.