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Abstract

Early identification of pulmonary exacerbations is vital for the management of cystic fibrosis (CF). Non-invasive airway sampling in preschool children can be inaccurate. Face mask sampling (FMS) is a novel non-invasive approach that can be used to assess microbial airway pathogens in patients with CF.

Prospective cross-sectional study in children with CF. Children wore a suitably sized face mask fitted with two strips of a polyvinyl alcohol sampling matrix for a period of 15 min. Routine microbiology sampling using cough swab, sputum and/or bronchoalveolar lavage was completed following FMS. Children then completed their routine airway clearance with their physiotherapist. Following this, a separate face mask was worn for a further 15 min, after which further routine microbiology sampling (cough swab or sputum) was completed. The face masks were stored at room temperature before transfer and processing in the laboratory to quantify bacterial burden and identify key pathogens such as and .

Eleven children (six male, median age 12 years, range 1–16 years), from the Leicester CF cohort were included. All patients tolerated the FMS. Nine face mask samples from 11 participants isolated respiratory pathogens, including (=3). was not detected on face mask samples. There was a trend towards an increase in microbial yield (prGen16s) following airway clearance (=5), but this did not reach statistical significance.

FMS systems are feasible for children and young people with CF. They may provide an effective method to detect exhaled lower airway pathogens including non-tuberculous mycobacteria. The effect of physiotherapy on the exhaled microbiome needs to be explored further.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
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/content/journal/jmm/10.1099/jmm.0.002150
2026-04-08
2026-04-14

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