Hypertonic Saline as a Useful Tool for Sputum Induction and Pathogen Detection in Cystic Fibrosis

Purpose The aim of this study was to compare the qualitative and semi-quantitative detection of pathogens in the airway secretions of patients with cystic fibrosis (CF) and the sputum induction capacity before and after inhalation of 7% hypertonic saline solution (HSS). Methods The study enrolled 64 patients with CF. Airway secretions were collected from all enrolled patients with CF before and after inhalation of 7% HSS, and the samples were screened for pathogens. Results Inhalation of 7% HSS increased the probability of producing sputum from 36 to 52% ( p = 0.002) in children with CF. The effect was most in children under 11 years. Inhalation of 7% HSS improved qualitative pathogen identification ( p = 0.008). Inhalation of 7% HSS increased the mucoid Pseudomonas aeruginosa ( p = 0.002) and non-mucoid P. aeruginosa in the semi-quantitative analysis ( p = 0.035). Four new pathogens ( Aspergillus fumigatus , Achromobacter xylosoxidans , Ochrobactrum anthropi , and Elizabethkingia meningoseptica ) were identified in the sputum samples collected from the airways of patients with CF following 7% HSS. Conclusions Inhalation of 7% HSS increased sputum production and pathogen identification in children with CF. The inhalation of 7% HSS was feasible and should be implemented for routine pathogen detection in the airways of patients with CF, particularly in those patients who do not produce sputum.