Gram Stain w/Sputum Cult Rflx
Evaluate the acceptability of a sputum specimen for aerobic bacterial culture and to determine the extent of culture work-up
The client will be notified of an unacceptable specimen. If the specimen is of good quality, a culture is performed for the isolation, identification, and, if necessary, antimicrobial susceptibility testing, of aerobic bacteria considered pathogenic in the lower respiratory tract.
Potential pathogens recovered by usual sputum culture methods include Staphylococcus aureus, Haemophilus influenzae, Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus parainfluenzae, Pseudomonas aeruginosa, Escherichia coli, Proteus sp, Moraxella catarrhalis, and rarely many other organisms. Haemophilus sp and Neisseria sp may not be routinely isolated and identified. Thus, if their presence is clinically suspected, they should be specifically requested. Agents such as Bordetella pertussis, Chlamydia pneumoniae Corynebacterium diphtheriae, Legionella pneumophila, Mycoplasma pneumoniae, and Mycobacterium tuberculosis require special laboratory measures for isolation. Clinical suspicion of involvement by these agents should be communicated to the laboratory.
5 to 10 mL sputum
1 to 2 mL sputum (minimum)
Sterile screw-cap container
The patient should be instructed to remove dentures, rinse mouth, and gargle with water. The patient should then be instructed to cough deeply and expectorate sputum into proper container. Be sure the patient understands the difference between sputum and saliva.
The patient should brush his/her teeth and/or rinse mouth well with water before attempting to collect the specimen to reduce the possibility of contaminating the specimen with food particles, oropharyngeal secretions, etc. The patient should be instructed that only a specimen brought forth by deep cough should be expectorated into the container. After the specimen has been collected, the specimen should be examined to make sure it contains a sufficient quantity (at least 1 mL) of thick mucus (notsaliva). Only the screw-cap container should be submitted to the laboratory.
Refrigerate at 2°C to 8°C
Unlabeled specimen or name discrepancy between specimen and request label; inappropriate specimen transport device; leaking specimen; specimen received after prolonged delay (usually more than 72 hours); poor quality sputum (contains many squamous epithelial cells due to contamination with saliva)