Abstract:
Diagnosing lung infections is often challenging because of the lack of a high-quality specimen from the diseased lung. Since persons with cystic fibrosis are subject to chronic lung infection, there is frequently a need for a lung specimen. In this small, proof of principle study, we determined that PneumoniaCheckTM, a non-invasive device that captures coughed droplets from the lung on a filter, might help meet this need. We obtained 10 PneumoniaCheckTMcoughed specimens and 2 sputum specimens from adult CF patients hospitalized with an exacerbation of their illness. We detected amylase (upper respiratory tract) with an enzymatic assay, surfactant A (lower respiratory tract) with an immunoassay, pathogenic bacteria by PCR, and markers of inflammation by a Luminex multiplex immunoassay. The amylase and surfactant A levels suggested that 9/10 coughed specimens were from lower respiratory tract with minimal upper respiratory contamination. The PCR assays detected pathogenic bacteria in 7 of 9 specimens and multiplex Luminex assay detected a variety of cytokines or chemokines. These data indicate that the PneumoniaCheckTMcoughed specimens can capture good quality lower respiratory tract specimens that have the potential to help in diagnosis, management and understanding of CF exacerbations and other lung disease.
摘要:
诊断肺部感染通常是具有挑战性的,因为缺乏来自患病肺部的高质量标本。由于囊性纤维化患者会受到慢性肺部感染,经常需要肺标本。在这个小小的,原理研究的证明,我们确定了肺炎,一种非侵入性装置,可以在过滤器上捕获肺部的咳嗽液滴,可以帮助满足这种需求。我们从因病情恶化而住院的成年CF患者中获得了10例PneumoniaCheckTM咳嗽标本和2例痰标本。我们用酶法检测淀粉酶(上呼吸道),表面活性剂A(下呼吸道)与免疫测定,通过PCR检测病原菌,和Luminex多重免疫测定的炎症标志物。淀粉酶和表面活性剂A水平表明9/10咳嗽标本来自下呼吸道,上呼吸道污染最小。PCR检测9份标本中的7份病原菌,多重Luminex检测检测多种细胞因子或趋化因子。这些数据表明,肺炎咳嗽标本可以捕获质量好的下呼吸道标本,有可能帮助诊断,对CF恶化和其他肺部疾病的管理和理解。