Sputum quality: Can you tell by looking?

Flournoy, D. J.; Davidson, Lance A.

doi:10.1016/0196-6553(93)90226-t

Cited by 6 publications

(3 citation statements)

References 13 publications

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“…In addition, one study found that some transtracheal samples may contain >10 epithelial cells per field while being suitable for culture, as suggested by a low number of bacterial species (1–4) [19], and other studies found that a cutoff of 25 epithelial cells provided an acceptable agreement between sputa and transtracheal aspirates [20, 21]. If the number of epithelial cells is not considered as an essential marker of sample quality, the aspect of sputum may be a reliable criterion by itself: in a study of 333 sputum samples, 87% of the mucopurulent specimens were microscopically adequate (i.e.contained >25 leukocytes per field), which corresponds exactly to what we found (87.5%) [22]. Finally, it must be outlined that all samples with positive culture results contained a predominant microbial population at direct examination.…”

Section: Discussionsupporting

confidence: 67%

Yield of Sputum Microbiological Examination in Patients Hospitalized for Exacerbations of Chronic Obstructive Pulmonary Disease with Purulent Sputum

et al. 2006

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Background: Whether sputum microbiological examination should be performed systematically in hospitalized patients with chronic obstructive pulmonary disease (COPD) exacerbations remains unclear. Objectives: To assess the yield of sputum microbiological examination in COPD patients hospitalized in a medical ward for an acute exacerbation with purulent sputum. Methods: Two hundred consecutive exacerbations in 118 patients were studied. Patients underwent sputum microbiological examination on admission and baseline lung function tests and CT scans were recorded. Factors associated with positive culture were analyzed. Results: Sputum culture was positive (≧10⁷ CFU/ml) in 59% of samples, Haemophilus influenzae and Streptococcus pneumoniae being the most frequent pathogens. Factors associated with positive culture were bronchiectasis, long-term oxygen therapy and low FEV₁. Pseudomonas spp. were found in 8.5% of all patients, who all had a FEV₁ <50% of predicted and were older. Only 25% of sputum samples satisfied all quality criteria. Sputum culture was positive in a high proportion of these samples (80.5%), but also in one half of samples with >25 leukocytes but >10 epithelial cells per field. Microbiological results induced a change in antibiotic therapy in 43.9% of cases with both quality criteria but also in 25.2% of cases with only one quality criterion. Finally, a predominant aspect after Gram stain was found in all positive samples. Conclusions: These data suggest that sputum microbiological examination with direct examination and leukocyte count should be performed routinely in patients hospitalized for COPD exacerbations with purulent sputum, especially when FEV₁ is less than 50% predicted and in patients with bronchiectasis.

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Section: Discussionsupporting

confidence: 67%

Yield of Sputum Microbiological Examination in Patients Hospitalized for Exacerbations of Chronic Obstructive Pulmonary Disease with Purulent Sputum

et al. 2006

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“…Also, sputum production in viral airway infections may be clear, white, or even tinged with blood [15]. It has been shown that a yellowish or greenish sputum colour is often related to the bacterial load of patients suffering from COPD exacerbation [16,17] or patients hospitalized due to respiratory conditions [18]. In otherwise healthy patients only indirect evidence showed that yellowish or greenish sputum did not influence outcomes with or without antibiotic therapy [19].…”

Section: Relationship To Other Studiesmentioning

confidence: 99%

Sputum colour for diagnosis of a bacterial infection in patients with acute cough

Altiner

Wilm

Däubener

et al. 2009

Scandinavian Journal of Primary Health Care

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“…Thus, some sputum properties such us consistency and appearance (watery, mucoid, purulent, bloodstained, etc.) have been related to good quality 1 . Moreover, other characteristics such as quantity, odour and the presence of particles or floccules may be of some interest as they can be of assistance when making a cytological diagnosis.…”

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confidence: 99%