Sputum Cultures

Sputum is not material from the postnasal region and is not spittle or saliva. A sputum specimen comes from deep within the bronchi. Effective coughing usually enables the patient to produce a satisfactory sputum specimen.

Indication for Collection
Sputum cultures are important for diagnosis of the following condition:
1. Bacterial pneumonia
2. Pulmonary TB
3. Chronic bronchitis
4. Bronchiectasis
5. Suspected pulmonary mycotic infections
6. Mycoplasmal pneumonia
7. Suspected viral pneumonia

Reference Values
Normal: negative normal oral flora

Produce
1. instruct patients to provide a deep cough specimen into sterile container. often, an early morning specimen is best. Expectorated material of 1 to 3 mL is sufficient for most examinations. remember that good sputum samples depend on through health care worker education and patient understanding during the collection process.
2. Label specimens properly and note to the suspected disease on the accompanying requistion.
3. Do not refrigerate speciments, and deliver to the laboratory as soon as possible.

Interventions

Pretest Patient Care
1. Record sign and symptoms (eg. coughing, productive sputum, blood in sputum)
2. Instruct the patient that this test requires tracheobronchial sputum deep in the lungs. Instruct the patient to take two or three deep breaths, then to take another deep breath and forcefully cough with exhalation.
3. Ask respiratory therapy personnel to assist the patient in obtaining an "aerosol-induced" specimen if the cough is not productive. Patients breathe aerosolized droplets of a sodium chloride-glycerine solution until a strong cough reflex is initiated. It should be noted on the requesition as being aerosol induced.
4. Remember that when pleural empyema is present, thoracentesis fluid and blood culture are excellent diagnostic speciment. Bronchial washing,BAL, and bronchial brush cultures are excellent for detecting most major pathogens of the respiratory ract.

Posttest Patient Care
1.Interpret test outcomes, counsel about treatment, and monitor for respiratory tract infections.