What is the diff between cought swab and sputem culture

[eli]

Hey all,

I will try and cut this short for ya all. A few months back my dd had an ongoing cough that i was concerned about, and still coughs a litlle now maybe 3-4 times a day. Now her clinic do not do cultures, as its not part of prctce.
They do yearly bronchs(i have explained this many time), anyway i have een hounding them to do a culture, as i have been concerned even though they thought she was fine.
So after a few months not the doc, but the pysio went ahead and did a cough swab, and said its the same.

I want to know how is it the same, is there a diff on what sort of bugs you can pick up via a cough swab and sputem culture?

Anyway they never called to tell me the results, so i called them. They said it wa all clear, but what aslo bothers me is that when the pysio did the swab, she didn't even realy cough for him to get anything and i am still concerned that they might of just done it to get me off there back about complaining, every visit.

Sorry its so long.

Thanks Eli

 

[JazzysMom]

There is a difference. Sputum comes more from the lung & a swab is taken from the throat area. The throat can be affected by sinuses which might or might not have the same bugs as the lungs. Even with sputum cultures you cant gaurantee every culture will be the same (as its been discussed in other posts recently) depending on where in the lung the sputum is being coughed from can change things. If one area is colonized with pseudomonas but you cough up something from a different area then the sputum isnt accurate. Point being that with the sputum itself it can be questionable nevermind a swab. HOWEVER; given your childs age...she cant cough up sputum (or unlikely to) upon demand for a culture thus the swab was done. What I dont know is when they do the yearly bronch can they or do they take cultures from that?

 

[Alyssa]

Eli,

I agree with Melissa but just wanted to add what we have been told by the nurse at our clinic -- the sputum cultures are most accurate for telling us what is growing in the lungs, but when a patient is unable to cough up a sputum sample, the next best thing is the cough swab (throat culture) to see what is growing on there... as it is an <b>indicator of what also might be growing in the lungs </b>-- so it is less accurate, but if they see something from the throat culture they can treat it, if they see nothing and the symptoms have not increased they will not give any antibiotics.

It is my understanding that all CF clinics follow (or should be following) the CFF guidelines for cultures and I thought that was cultures every three months (ideally sputum, but throat culture if no sputum is available) I don't understand why this should be a fight for you, they should be the ones telling you it is standard procedure for them to do it! Sorry if you have already explained something about your clinic before -- I don't sign on all that often any more so I could have missed it.

 

[anonymous]

I wish all CF Centers did it every 3 months...I have to ask my doctor to do mine half the time. The only time he does it voluntarily is when he thinks I need IV's.

 

[anonymous]

My daughter has cough swab taken every 2 months when she visits the CF Clinic for her check up. If she has a cold she has an extra one during that and after. I don't always go off the result, more 2 how she is in herself though, cos as stated by other much more experienced people than me it isn't a sputum sample, only a cough swab. That's when her Pseudo showed up when she was 10 months old.

Charlotte<img src="i/expressions/face-icon-small-happy.gif" border="0">

 

[julie]

Eli,

I ditto what melissa and alyssa have said about the difference between sputum cultures and cough swabs. At this point though your daughter is too young to cough and bring up the sputum they would need, even if they did do sputum cultures. Sure she can cough, and might hack up some nasty stuff sometimes, but if she's like most kids, she just swallows it again. It is good you are asking and getting this figured out now though because when she does get old enough to cough it up, the sputum will be more accurate than the cough swab and should be used. Definately a concern to discuss with your clinic for the future.

Many parents work with their kids on coughing and spitting it out into an appropriate place (i.e. excuses yourself to the bathroom, spit into a napkin/tissue and NOT on the ground... things like that). I remember Marks mom saying she had to sit with him when he was about 18-24 months (shortly after the diagnosis) and teach him how to cough deeply and bring up the sputum. Not only to clear his throat when he needed to (becaus he had mastered this) but bringing it UP instead of swallowing it so the doctors could get a sample.

It's never too early to start working on it, but it will take some time <img src="i/expressions/face-icon-small-smile.gif" border="0">

God luck with all of this and I hope your little one feels better!

 

[eli]

Hey all, thanks for your replies.

Melissa, you asked if they do a culture during a bronch. No, this clinic does not do cultures at all, that's what bugs me. I don't no of any other clinic that doesn't, don't get me wrong i love the doc's and nurses there, they do a great job. I just don't like their theory on not doing cultures.
From what i understand, when the bronch is done they check for redness/inflamation/lung damage. That's all i know.

Alysssa, you stated why is it a fight for me to have this done. Well i think because the doc's here have mentioned they haven't seen it to be useful(don't ask me why, it seems logical to me that it is), and its not part of their protocol, so to speak. I'm aware that clinics here do not do the same care, they all have thier own reserch that they conduct, and their own theories on what works better. The two clinics in our area, have a total diff approach to cf and treatments. Waht worries me is that i don't know which one is better, who is doing the right thing?

I'm so confused!

Julie, thanks for your helpful info. Olivia will cough, but does not spit it out she swallows. But like you said it will take time for her to learn this.

Thanks again to everyone.
Eli