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.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Barrett-Connor E. The nonvalue of sputum culture in the diagnosis of pneumococcal pneumonia. Am Rev Respir Dis. 1971 Jun;103(6):845–848. doi: 10.1164/arrd.1971.103.6.845. [DOI] [PubMed] [Google Scholar]
- Curione C. J., Jr, Kaneko G. S., Voss J. L., Hesse F., Smith R. F. Gram stain evaluation of the quality of sputum specimens for mycobacterial culture. J Clin Microbiol. 1977 Mar;5(3):381–382. doi: 10.1128/jcm.5.3.381-382.1977. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- Kalinske R. W., Parker R. H., Brandt D., Hoeprich P. D. Diagnostic usefulness and safety of transtracheal aspiration. N Engl J Med. 1967 Mar 16;276(11):604–608. doi: 10.1056/NEJM196703162761103. [DOI] [PubMed] [Google Scholar]
- Levin D. C., Schwarz M. I., Matthay R. A., LaForce F. M. Bacteremic hemophilus influenzae pneumonia in adults. A report of 24 cases and a review of the literature. Am J Med. 1977 Feb;62(2):219–224. doi: 10.1016/0002-9343(77)90317-5. [DOI] [PubMed] [Google Scholar]
- 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]
- Van Scoy R. E. Bacterial sputum cultures. A clinician's viewpoint. Mayo Clin Proc. 1977 Jan;52(1):39–41. [PubMed] [Google Scholar]