RT Journal Article SR Electronic T1 Chest physiotherapy enhances detection of Pseudomonas aeruginosa in nonexpectorating children with cystic fibrosis JF ERJ Open Research JO erjor FD European Respiratory Society SP 00513-2020 DO 10.1183/23120541.00513-2020 VO 7 IS 1 A1 Christophe Marguet A1 Véronique Houdouin A1 Isabelle Pin A1 Philippe Reix A1 Frédéric Huet A1 Marie Mittaine A1 Sophie Ramel A1 Nathalie Wizla-Derambure A1 Michel Abely A1 Marie-Laure Dalphin A1 Michael Fayon A1 Tiphaine Bihouée A1 Muriel Le Bourgeois A1 Eric Deneuville A1 Harriet Corvol A1 Muriel Laurans A1 Laure Couderc A1 Evelyne Leroux A1 Ludovic Lémée YR 2021 UL http://openres.ersjournals.com/content/7/1/00513-2020.abstract AB Lung damage in cystic fibrosis (CF) is strongly associated with lower airway infections. Early treatment of Pseudomonas aeruginosa is recommended. Pathogen detection requires sampling of lower airway secretions, which remains a challenge in nonexpectorating patients. Our hypothesis was that chest physiotherapy would improve the quality of airway secretion samples and increase the rates of pathogens detected in nonexpectorating patients.This prospective multicentre study compared three successive methods for sampling airway secretions applied through the same session: 1) an oropharyngeal swab (OP), 2) a chest physiotherapy session followed by a provoked cough to obtain sputum (CP-SP) and 3) a second oropharyngeal swab collected after chest physiotherapy (CP-OP). Haemophilus influenzae, Staphylococcus aureus and P. aeruginosa growth cultures were assessed. Accuracy tests and an equivalence test were performed to compare the three successive methods of collection.300 nonexpectorating children with CF were included. P. aeruginosa was detected cumulatively in 56 (18.9%) children, and according to the different collection methods in 28 (9.8%), 37 (12.4%) and 44 (14.7%) children by using OP, CP-OP and CP-SP, respectively. Compared with OP, the increased detection rate was +22% for CP-OP (p=0.029) and +57% for CP-SP (p=0.003). CP-SP had the best positive predictive value (86.3%) and negative predictive value (96.0%) for P. aeruginosa compared with the overall detection.The results of this adequately powered study show differences in the rates of pathogens detected according to the sampling method used. Chest physiotherapy enhanced detection of P. aeruginosa in nonexpectorating children with CF.Sputum collection after a chest physiotherapy session strongly enhances the detection of P. aeruginosa in nonexpectorating CF children compared with the commonly used oropharyngeal swab method. Oropharyngeal swab after physiotherapy may be an acceptable alternative. https://bit.ly/3757ewq