Nasal Irrigation in Cystic Fibrosis Shows Diagnostic Potential
NASAL irrigation could provide a practical, non-invasive alternative for monitoring airway microbiology in people with cystic fibrosis, new findings suggest.
Comparing Nasal Irrigation and Sputum Sampling
In this study, individuals with cystic fibrosis (pwCF) who were suspected of chronic rhinosinusitis provided both nasal irrigation and expectorated sputum samples on the same day. The aim was to determine whether nasal irrigation could detect bacterial pathogens found in sputum, the standard reference for airway infection monitoring.
Among 103 paired samples, nasal irrigation achieved strong diagnostic accuracy for two of the most common bacterial infections affecting pwCF. The sensitivity and specificity for Pseudomonas aeruginosa were 84% and 91%, respectively, while results for Staphylococcus aureus reached 79% and 85%. These findings indicate high concordance between the nasal and sputum samples for bacterial detection.
Limitations in Detecting Fungal Pathogens
However, nasal irrigation was far less effective for identifying fungal pathogens, showing a sensitivity of only 0.4%. This underscores its limited role in detecting fungal infections of the lower respiratory tract, where sputum sampling remains essential.
Implications for Clinical Practice
These results support nasal irrigation as a promising complementary or alternative diagnostic tool for bacterial monitoring in cystic fibrosis, particularly for patients unable to produce sputum or those with coexisting sinus disease. Further research is needed to assess its diagnostic yield in children and adults without chronic rhinosinusitis symptoms.
Expanding on these findings, the researchers emphasized that nasal irrigation could improve patient comfort and adherence by reducing the need for invasive sampling methods. The technique may also facilitate more frequent monitoring of bacterial colonization, enabling earlier detection and intervention. If validated in larger cohorts, nasal irrigation could streamline infection surveillance in cystic fibrosis care.
Reference: Lazarus R et al. Nasal irrigation as an alternate method to monitor airway microbiology in cystic fibrosis. J Cyst Fibros. 2025:S1569-1993(25)02487-7.
