Microscopic and bacteriological comparison of paired sputa and transtracheal aspirates

Abstract

Ninety-six sputum specimens from patiens with pneumonia were microscopically screened for leukocytes and buccal squamous epithelial (BSE) cells. Cultures of these specimens were compared with cultures of paired transtracheal aspirates (TTA). Agreement between sputa with less than 25 BSE cells per 100X field and TTA was good (79%). Only 27% of the specimens with greater than 25 BSE cells per 100X field agreed with TTA. Sixty-six of the sputa were of group 5 quality, i.e., greater than 25 leukocytes and less than 10 BSE cells per 100X field. A potential pathogen growing in one of these specimens was 94% predictive of growth in the TTA. If a group 5 sputum was negative for a potential pathogen, there was a 45% chance that a fastidious organism had been overgrown or overlooked. The presence of definite lower tract secretions in group 5 sputa as determined by visualizing bronchial epithelial cells and alveolar macrophages did not significantly increase the diagnostic value of these specimens. Microscopic screening of sputum before culture with rejection of selected specimens can increase the value of sputum in determining the etiology of bacterial pneumonia.

Utility of Polymerase Chain Reaction in Nasopharyngeal Swabs for Identifying Respiratory Bacteria Causing Community-Acquired Pneumonia

“…Exclusion criteria were absence of LRTI (defined as an acute illness of ≤21 days, with cough as the main symptom, with ≥1 other lower respiratory tract symptom [sputum production, dyspnea, and/or chest discomfort/pain], and no alternative explanation) ( 27 ), presence of chronic lung disease (bronchiectasis, cystic fibrosis), hospitalization in an acute care hospital in the last 3 months, a low-quality sputum or lung aspirate (quality criteria defined as ≥25 neutrophils and <10 epithelial cells per low-power field) ( 28 ), upper and lower respiratory tract samples collected with a delay of ≥24 h, sample collection more than 48 h after admission, and refusal to participate in the study.…”

Association between the point-rating system used for oral health and the prevalence of Gram-negative bacilli in hematological inpatients

“…Moreover, Geckler's classification of macroscopic sputum findings and Miller and Jones’ classification of microscopic findings were employed to avoid collecting sputum samples contaminated with saliva and upper respiratory tract secretions. [ 45 , 46 ] The M1 class sputum – based on the Miller and Jones’ classification – which is viscous and consists mostly of saliva, was excluded. [ 46 ] Alternatively, good-quality sputum, based on Geckler's classification (classes 3, 4, and 5), was collected.…”

“…[ 46 ] Alternatively, good-quality sputum, based on Geckler's classification (classes 3, 4, and 5), was collected. [ 45 ] The samples were delivered to the laboratory immediately after collection and were subjected to Gram staining and isolation according to standard techniques. Three types of agar plates were used, namely, bromothymol blue lactose, sheep blood, and chocolate.…”

Impact of chronic co-infection in pulmonary Mycobacterium avium complex disease after treatment initiation

“…The Geckler classification of sputum examination is shown in Additional file 1 : Table S1. The pathogenic microorganism was detected in 10 of the 12 patients in the co-infection group, at least once from examination of high-quality sputum samples (Geckler classification 4 or 5) [ 10 ].…”