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Sweat collection for testing in Canadian Cystic Fibrosis Centers, is it optimal?
M Beauchamp1, V Grey, L C Lands
1Montreal Children's Hospital-McGill University Medical Centre, 2300 Tupper St., Room D-380, Montreal, QC, Canada, H3H 1P3.
Insights
Canadian cystic fibrosis (CF) centers struggle with sweat testing for infants under 3 months, leading to high rates of insufficient sweat volumes. Standardization is needed to improve diagnostic accuracy and reduce delays.
Area of Science:
- Pediatrics
- Pulmonology
- Medical Diagnostics
Background:
- Cystic Fibrosis (CF) diagnosis relies heavily on sweat testing.
- Infants under 3 months present unique challenges for accurate sweat testing.
Purpose of the Study:
- To evaluate the capacity of Canadian CF centers to perform sweat testing.
- To specifically assess sweat testing in infants under 3 months old.
Main Methods:
- A survey was distributed to 37 Canadian CF centers.
- Results analyzed the ability to obtain adequate sweat volumes in infants <3 months.
Main Results:
- Median insufficient sweat volume rate was 18.3% in infants <3 months vs. 4.5% in older patients.
- 15 of 19 centers reported >5% insufficient tests in infants <3 months.
- 6 of 19 centers reported >5% insufficient sweat volumes in older children and adults.
Conclusions:
- Current Canadian CF centers face challenges in obtaining sufficient sweat volumes, particularly in infants.
- Standardizing sweat testing procedures is crucial to reduce insufficient results and diagnostic delays.
Objectives:
The goal of this study was to examine the ability of the current Canadian CF center network to conduct sweat testing, with a particular focus on testing in infants less than 3 months old.
Methods:
Surveys were sent to the 37 CF centers in Canada supported by the Canadian CF Foundation, and results were interpreted with respect to their ability to obtain adequate sweat volumes in children less than 3 months and potential factors influencing these results.
Results:
Ten centers that care for adult patients referred patients to their local pediatric CF center for sweat testing; the remaining 27 centers conducted sweat tests and 26 responded. Insufficient sweat volume results in children <3 months occurred in a median of 18.3% of tests. The corresponding proportion for the remaining population was 4.5% (P < 0.001). 15 of 19 centers had an incidence of >5% of insufficient tests in children <3 months of age, and 9 of 19 had an incidence of <20% in this age group. Six of 19 had an incidence of >5% of insufficient sweat volumes in older children and adults.
Conclusions:
Standardization of testing procedures is required to reduce the rates of insufficient sweat volumes in both infants less than 3 months old and children >3 months old. This will decrease the need for repeat testing and delay in diagnosis.
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