Home Microbiological Sampling in a Pediatric Cystic Fibrosis Population: Pandemic Implementation and Ongoing Use

Area of Science:

• Medical Microbiology
• Pulmonology
• Infectious Disease Epidemiology

Background:

• The COVID-19 pandemic necessitated adaptations in healthcare delivery, impacting routine microbiological surveillance in cystic fibrosis (CF) care.
• Home-based airway sampling strategies emerged as a critical alternative to in-clinic procedures.
• The study addresses the need to review the validity and ongoing utility of these home-based sampling methods.

Purpose of the Study:

• To evaluate the frequency of home versus in-clinic airway sampling in CF patients.
• To compare the positivity rates of significant CF pathogens between home and in-clinic samples.
• To assess the impact of the COVID-19 pandemic on sampling practices.

Main Methods:

• A single-center, retrospective cohort study analyzed airway culture data from children with CF.
• Data spanned from January 2019 to May 2023, encompassing periods before, during, and after COVID-19 restrictions.
• Culture locations (home vs. clinic) were verified manually from patient records.

Main Results:

• A total of 2,638 cultures from 170 CF patients were analyzed.
• Home-collected samples showed a higher overall pathogen positivity rate (rate ratio: 1.46).
• Only other gram-negative bacilli demonstrated significantly higher positivity in home-collected samples (rate ratio: 1.69).

Conclusions:

• Home airway sampling demonstrates comparable positivity rates for clinically significant CF pathogens to in-clinic sampling.
• This suggests home-based methods are a viable alternative for microbiological surveillance.
• Further prospective research is recommended to definitively confirm the comparability of home and clinic sampling techniques.