Sputum Quality Assessment Regarding Sputum Culture for Diagnosing Lower Respiratory Tract Infections in Children

Abstract

BACKGROUND: The clinical relevance of specimens from the lower airways is often debatable. However, they are most commonly examined for diagnosing lower respiratory tract infections (LRTIs).AIM: This study aimed to determine the diagnostic value of sputum quality assessment about sputum culture for diagnosing LRTIs in children.METHODS: In six months, a total of 1485 sputum samples were quality assessed by using Bartlett’s grading system. All samples, regardless of their quality, were cultured, identified, and antimicrobial susceptibility testing was performed by Kirby-Bauer disc-diffusion method.RESULTS: Among the acceptable category, defined by Bartlett’s grading system, 132 (63.2%) samples showed culture positivity of which Streptococcus pneumoniae 48 (36.4%) was most commonly isolated, followed by Moraxella catarrhalis 22 (16.7%) and Haemophilus influenza 21 (15.9%). Among the non-acceptable category, 185 (14.5%) samples were culture positive of which most commonly isolated were Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa with 64 (34.6%), 54 (29.2%) and 28 (15.1%), respectively.CONCLUSION: Sputum quality assessment is a useful tool for distinguishing the true respiratory pathogens from possible colonising flora for which antibiotic treatment should not be highly considered.

Pathogens detected using a syndromic molecular diagnostic platform in patients hospitalized with severe respiratory illness in South Africa in 2017

“…Conversely, detection of these pathogens in sputum can also be a result of a contamination with upper respiratory tract flora due to poor specimen collection procedures and so may have overestimated the reported detection rates. Future studies could include assessment of sputum quality, such as using the Bartlett grading system ( Popova et al ., 2019 ). Also, detection of these pathogens in blood can be as a result of transient bacteremia, further overestimating their role in SRI.…”

A diagnostic test: combined detection of heparin-binding protein, procalcitonin, and C-reactive protein to improve the diagnostic accuracy of bacterial respiratory tract infections

“…Bacterial RTIs are common in hospitalized patients. Sputum culture remains the gold standard for the diagnosis of RTIs, but its diagnostic efficiency is limited by the low sampling quality of the sputum specimens and by the low positivity rate, poor reliability, and long testing period of the culture (2). Inflammatory markers, including heparin-binding protein (HBP), procalcitonin (PCT) and C-reaction protein (CRP), as they can help diagnose bacterial infection quickly and early, have been increasingly used in the diagnosis of bacterial RTIs (3)(4)(5); however, a single marker can be released in the blood due to the occurrence of one or more illness, often fails to support an accurate diagnosis of the disease.…”

Microbiologic and virulence characteristics of Moraxella catarrhalis isolates from Zambian children presenting with acute pneumonia

“…Pulmonary excretions were aspirated using a pump and sputum specimens were collected into a sterile trap. Sputum quality was assessed on Gram‐stained slides using the Bartlett score, 13 and only sputum specimens of high bacteriological quality were analyzed (<10 epithelial cells, >25 leukocytes/low power field). The presence of bacteria on the slides was also noted.…”