Skip to main content
PMC home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1978 Aug;31(8):724–729. doi: 10.1136/jcp.31.8.724

Evaluation of some methods for the laboratory examination of sputum.

G M Tebbutt, D J Coleman
PMCID: PMC1145396  PMID: 99457

Abstract

Methods for the quantitation of leucocytes, squamous epithelial cells, and potential pathogens in sputa are described. Microscopic examination showed that 58% of sputa tested (554/957) were purulent or moderately purulent and 48% were moderately or heavily contaminated by squamous epithelial cells. The presence of squamous epithelial cells indicated oropharyngeal contamination. A simple dilution technique was chosen to compare the isolation of potential pathogens from direct cultures and from dilutions of sputa (10(-7) per ml original sputum). The dilution technique permitted easier reading of sputum cultures and avoided the possible over-reporting of enterobacteria and Pseudomonas aeruginosa, which were frequently found on direct examination. Enterobacteria and Pseudomonas aeruginosa were more likely to be isolated from sputa moderately or heavily contaminated with squamous epithelial cells. The use of counter-current immunoelectrophoresis (CIE) and co-agglutination tests to detect pneumococcal antigen in sputa is described. The presence of antigen in sputum was a more reliable index of lower respiratory tract infection than a positive culture. Co-agglutination tests were simpler to perform and used smaller amounts of expensive antiserum than CIE.

Full text

PDF
724

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BRUMFITT W., WILLOUGHBY M. L., BROMLEY L. L. An evaluation of sputum examination in chronic bronchitis. Lancet. 1957 Dec 28;273(7009):1306–1309. doi: 10.1016/s0140-6736(57)91637-9. [DOI] [PubMed] [Google Scholar]
  2. Dixon J. M., Miller D. C. Value of dilute inocula in cultural examination of sputum. Lancet. 1965 Nov 20;2(7421):1046–1048. doi: 10.1016/s0140-6736(65)90572-6. [DOI] [PubMed] [Google Scholar]
  3. El-Refaie M., Dulake C. Counter-current immunoelectrophoresis for the diagnosis of pneumococcal chest infection. J Clin Pathol. 1975 Oct;28(10):801–806. doi: 10.1136/jcp.28.10.801. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Hahn H. H., Beaty H. N. Transtracheal aspiration in the evaluation of patients with pneumonia. Ann Intern Med. 1970 Feb;72(2):183–187. doi: 10.7326/0003-4819-72-2-183. [DOI] [PubMed] [Google Scholar]
  5. Jordan G. W., Wong G. A., Hoeprich P. D. Bacteriology of the lower respiratory tract as determined by fiber-optic bronchoscopy and transtracheal aspiration. J Infect Dis. 1976 Nov;134(5):428–435. doi: 10.1093/infdis/134.5.428. [DOI] [PubMed] [Google Scholar]
  6. Kronvall G. A rapid slide-agglutination method for typing pneumococci by means of specific antibody adsorbed to protein A-containing staphylococci. J Med Microbiol. 1973 May;6(2):187–190. doi: 10.1099/00222615-6-2-187. [DOI] [PubMed] [Google Scholar]
  7. Murray P. R., Washington J. A. Microscopic and baceriologic analysis of expectorated sputum. Mayo Clin Proc. 1975 Jun;50(6):339–344. [PubMed] [Google Scholar]
  8. Pirtle J. K., Monroe P. W., Smalley T. K., Mohr J. A., Rhoades E. R. Diagnostic and therapeutic advantages of serial quantitative cultures of fresh sputum in acute bacterial pneumonia. Am Rev Respir Dis. 1969 Dec;100(6):831–838. doi: 10.1164/arrd.1969.100.6.831. [DOI] [PubMed] [Google Scholar]
  9. Spencer R. C., Savage M. A. Use of Counter and rocket immunoelectrophoresis in acute respiratory infections due to Streptococcus pneumoniae. J Clin Pathol. 1976 Mar;29(3):187–190. doi: 10.1136/jcp.29.3.187. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Stevens R. M., Teres D., Skillman J. J., Feingold D. S. Pneumonia in an intensive care unit. A 30-month experience. Arch Intern Med. 1974 Jul;134(1):106–111. [PubMed] [Google Scholar]
  11. Tebbutt G. M., Coleman D. J., McGhie D. Grouping of beta-haemolytic streptococci with group-specific antibodies absorbed to staphylococcal protein A. J Clin Pathol. 1976 Dec;29(12):1085–1087. doi: 10.1136/jcp.29.12.1085. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Thorsteinsson S. B., Musher D. M., Fagan T. The diagnostic value of sputum culture in acute pneumonia. JAMA. 1975 Aug 25;233(8):894–895. [PubMed] [Google Scholar]
  13. Verhoef J., Jones D. M. Letter: Pneumococcal antigen in sputum. Lancet. 1974 May 4;1(7862):879–879. doi: 10.1016/s0140-6736(74)90544-3. [DOI] [PubMed] [Google Scholar]
  14. Wilkinson P. J., Ball A. J., Doran J., Gillespie W. A., Orton V. S. Routine laboratory assessment of postoperative chest infection: a prospective study. J Clin Pathol. 1977 May;30(5):417–420. doi: 10.1136/jcp.30.5.417. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES