Safety of induced sputum collection in children hospitalized with severe or very severe pneumonia

PERCH Study Group

Research output: Contribution to journalArticle

Abstract

Background. Induced sputum (IS) may provide diagnostic information about the etiology of pneumonia. The safety of this procedure across a heterogeneous population with severe pneumonia in low- and middle-income countries has not been described. Methods. IS specimens were obtained as part a 7-country study of the etiology of severe and very severe pneumonia in hospitalized children <5 years of age. Rigorous clinical monitoring was done before, during, and after the procedure to record oxygen requirement, oxygen saturation, respiratory rate, consciousness level, and other evidence of clinical deterioration. Criteria for IS contraindications were predefined and serious adverse events (SAEs) were reported to ethics committees and a central safety monitor. Results. A total of 4653 IS procedures were done among 3802 children. Thirteen SAEs were reported in relation to collection of IS, or 0.34% of children with at least 1 IS specimen collected (95% confidence interval, 0.15%-0.53%). A drop in oxygen saturation that required supplemental oxygen was the most common SAE. One child died after feeding was reinitiated 2 hours after undergoing sputum induction; this death was categorized as "possibly related" to the procedure. Conclusions. The overall frequency of SAEs was very low, and the nature of most SAEs was manageable, demonstrating a lowrisk safety profile for IS collection even among severely ill children in low-income-country settings. Healthcare providers should monitor oxygen saturation and requirements during and after IS collection, and assess patients prior to reinitiating feeding after the IS procedure, to ensure patient safety.

Original languageEnglish (US)
Pages (from-to)S301-S308
JournalClinical Infectious Diseases
Volume64
DOIs
StatePublished - Jan 1 2017

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Hospitalized Child
Sputum
Pneumonia
Safety
Oxygen
Ethics Committees
Patient Safety
Respiratory Rate
Consciousness
Health Personnel
Confidence Intervals

Keywords

  • Induced sputum
  • PERCH
  • Safety
  • Severe pneumonia
  • Very severe pneumonia

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Safety of induced sputum collection in children hospitalized with severe or very severe pneumonia. / PERCH Study Group.

In: Clinical Infectious Diseases, Vol. 64, 01.01.2017, p. S301-S308.

Research output: Contribution to journalArticle

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title = "Safety of induced sputum collection in children hospitalized with severe or very severe pneumonia",
abstract = "Background. Induced sputum (IS) may provide diagnostic information about the etiology of pneumonia. The safety of this procedure across a heterogeneous population with severe pneumonia in low- and middle-income countries has not been described. Methods. IS specimens were obtained as part a 7-country study of the etiology of severe and very severe pneumonia in hospitalized children <5 years of age. Rigorous clinical monitoring was done before, during, and after the procedure to record oxygen requirement, oxygen saturation, respiratory rate, consciousness level, and other evidence of clinical deterioration. Criteria for IS contraindications were predefined and serious adverse events (SAEs) were reported to ethics committees and a central safety monitor. Results. A total of 4653 IS procedures were done among 3802 children. Thirteen SAEs were reported in relation to collection of IS, or 0.34{\%} of children with at least 1 IS specimen collected (95{\%} confidence interval, 0.15{\%}-0.53{\%}). A drop in oxygen saturation that required supplemental oxygen was the most common SAE. One child died after feeding was reinitiated 2 hours after undergoing sputum induction; this death was categorized as {"}possibly related{"} to the procedure. Conclusions. The overall frequency of SAEs was very low, and the nature of most SAEs was manageable, demonstrating a lowrisk safety profile for IS collection even among severely ill children in low-income-country settings. Healthcare providers should monitor oxygen saturation and requirements during and after IS collection, and assess patients prior to reinitiating feeding after the IS procedure, to ensure patient safety.",
keywords = "Induced sputum, PERCH, Safety, Severe pneumonia, Very severe pneumonia",
author = "{PERCH Study Group} and Andrea Deluca and Hammitt, {Laura L} and Kim, {Julia Minjung} and Melissa Higdon and Baggett, {Henry C.} and Brooks, {W Abdullah} and Howie, {Stephen R.C.} and Knoll, {Maria Deloria} and Kotloff, {Karen L.} and Levine, {Orin S.} and Madhi, {Shabir A.} and Murdoch, {David R.} and Scott, {J. Anthony G.} and Thea, {Donald M.} and Tussanee Amornintapichet and Awori, {Juliet O.} and Somchai Chuananon and Driscoll, {Amanda J.} and Ebruke, {Bernard E.} and Lokman Hossain and Yasmin Jahan and Kagucia, {Eunice Wangeci} and Sidi Kazungu and Moore, {David P.} and Azwifarwi Mudau and Lawrence Mwananyanda and Park, {Daniel E.} and Christine Prosperi and Phil Seidenberg and Mamadou Sylla and Tapia, {Milagritos D.} and Zaman, {Syed M.A.} and O'Brien, {Katherine L} and Daniel Feikin and Nicholas Fancourt and Wei Fu and Karron, {Ruth A} and Mengying Li and Zhenke Wu and Scott Zeger and Watson, {Nora L.} and Jane Crawley and Endtz, {Hubert P.} and Khalequ Zaman and Doli Goswami and Hasan Ashraf and Martin Antonio and Jessica McLellan and Eunice Machuka and Arifin Shamsul",
year = "2017",
month = "1",
day = "1",
doi = "10.1093/cid/cix078",
language = "English (US)",
volume = "64",
pages = "S301--S308",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",

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TY - JOUR

T1 - Safety of induced sputum collection in children hospitalized with severe or very severe pneumonia

AU - PERCH Study Group

AU - Deluca, Andrea

AU - Hammitt, Laura L

AU - Kim, Julia Minjung

AU - Higdon, Melissa

AU - Baggett, Henry C.

AU - Brooks, W Abdullah

AU - Howie, Stephen R.C.

AU - Knoll, Maria Deloria

AU - Kotloff, Karen L.

AU - Levine, Orin S.

AU - Madhi, Shabir A.

AU - Murdoch, David R.

AU - Scott, J. Anthony G.

AU - Thea, Donald M.

AU - Amornintapichet, Tussanee

AU - Awori, Juliet O.

AU - Chuananon, Somchai

AU - Driscoll, Amanda J.

AU - Ebruke, Bernard E.

AU - Hossain, Lokman

AU - Jahan, Yasmin

AU - Kagucia, Eunice Wangeci

AU - Kazungu, Sidi

AU - Moore, David P.

AU - Mudau, Azwifarwi

AU - Mwananyanda, Lawrence

AU - Park, Daniel E.

AU - Prosperi, Christine

AU - Seidenberg, Phil

AU - Sylla, Mamadou

AU - Tapia, Milagritos D.

AU - Zaman, Syed M.A.

AU - O'Brien, Katherine L

AU - Feikin, Daniel

AU - Fancourt, Nicholas

AU - Fu, Wei

AU - Karron, Ruth A

AU - Li, Mengying

AU - Wu, Zhenke

AU - Zeger, Scott

AU - Watson, Nora L.

AU - Crawley, Jane

AU - Endtz, Hubert P.

AU - Zaman, Khalequ

AU - Goswami, Doli

AU - Ashraf, Hasan

AU - Antonio, Martin

AU - McLellan, Jessica

AU - Machuka, Eunice

AU - Shamsul, Arifin

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background. Induced sputum (IS) may provide diagnostic information about the etiology of pneumonia. The safety of this procedure across a heterogeneous population with severe pneumonia in low- and middle-income countries has not been described. Methods. IS specimens were obtained as part a 7-country study of the etiology of severe and very severe pneumonia in hospitalized children <5 years of age. Rigorous clinical monitoring was done before, during, and after the procedure to record oxygen requirement, oxygen saturation, respiratory rate, consciousness level, and other evidence of clinical deterioration. Criteria for IS contraindications were predefined and serious adverse events (SAEs) were reported to ethics committees and a central safety monitor. Results. A total of 4653 IS procedures were done among 3802 children. Thirteen SAEs were reported in relation to collection of IS, or 0.34% of children with at least 1 IS specimen collected (95% confidence interval, 0.15%-0.53%). A drop in oxygen saturation that required supplemental oxygen was the most common SAE. One child died after feeding was reinitiated 2 hours after undergoing sputum induction; this death was categorized as "possibly related" to the procedure. Conclusions. The overall frequency of SAEs was very low, and the nature of most SAEs was manageable, demonstrating a lowrisk safety profile for IS collection even among severely ill children in low-income-country settings. Healthcare providers should monitor oxygen saturation and requirements during and after IS collection, and assess patients prior to reinitiating feeding after the IS procedure, to ensure patient safety.

AB - Background. Induced sputum (IS) may provide diagnostic information about the etiology of pneumonia. The safety of this procedure across a heterogeneous population with severe pneumonia in low- and middle-income countries has not been described. Methods. IS specimens were obtained as part a 7-country study of the etiology of severe and very severe pneumonia in hospitalized children <5 years of age. Rigorous clinical monitoring was done before, during, and after the procedure to record oxygen requirement, oxygen saturation, respiratory rate, consciousness level, and other evidence of clinical deterioration. Criteria for IS contraindications were predefined and serious adverse events (SAEs) were reported to ethics committees and a central safety monitor. Results. A total of 4653 IS procedures were done among 3802 children. Thirteen SAEs were reported in relation to collection of IS, or 0.34% of children with at least 1 IS specimen collected (95% confidence interval, 0.15%-0.53%). A drop in oxygen saturation that required supplemental oxygen was the most common SAE. One child died after feeding was reinitiated 2 hours after undergoing sputum induction; this death was categorized as "possibly related" to the procedure. Conclusions. The overall frequency of SAEs was very low, and the nature of most SAEs was manageable, demonstrating a lowrisk safety profile for IS collection even among severely ill children in low-income-country settings. Healthcare providers should monitor oxygen saturation and requirements during and after IS collection, and assess patients prior to reinitiating feeding after the IS procedure, to ensure patient safety.

KW - Induced sputum

KW - PERCH

KW - Safety

KW - Severe pneumonia

KW - Very severe pneumonia

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UR - http://www.scopus.com/inward/citedby.url?scp=85042397087&partnerID=8YFLogxK

U2 - 10.1093/cid/cix078

DO - 10.1093/cid/cix078

M3 - Article

C2 - 28575356

AN - SCOPUS:85042397087

VL - 64

SP - S301-S308

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

ER -