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Sputum

  • Routine bacterial culture
  • Cystic fibrosis
  • Limitations

 Routine bacterial culture

Clinical details required

If the sample is from an intensive care setting than we will automatically look for MRSA, Coliforms and Candida. If these are ever suspected please request them specifically giving appropriate reasons.

It is important to inform the laboratory of clinical information such as:

  • Current and past antimicrobial treatment
  • Bronchiectasis
  • Travel history
  • Oral candidiasis
  • Immuno-suppression (of any kind)
  • Alcoholism/ IVDU
  • Diabetes
  • Cystic fibrosis
  • Recent infections
  • Recent hospital admissions
  • Ventilation
  • Aspiration
  • Lung abscesses
  • Cystic fibroisis

These details mean that the sample may be treated slightly differently to the routine ones or they could be cultured to ensure a wider range of organisms are looked for that are specific to these types of patients

If no clinical details are given then a basic culture is performed, this is usually sufficient for most routine patients but may be detrimental particularly to those with chronic/ systemic infections.

Cystic fibrosis

Cystic fibrosis patients are at a higher risk developing respiratory tract infections. This group of patients are more susceptible to infections caused by Pseudomonas spp, Staphylococcus aureus, Candida spp, fungi and in severe cases Burkholderia cenocepacia complex. These organisms are targeted in our culture methods so long as we are informed on the request form the patient has cystic fibrosis.

Limitations

Salivary samples are not of suitable quality for culture as the oral normal flora can overgrow the pathogens therefore resulting in a ‘negative’ culture.

We need at least 2ml of sample in a sterile universal. If other tests are required such as virology/ PCP, please send a separate sample where possible and include all significant clinical details on the request form.

Cough swabs are not suitable samples but can be used only in children with cystic fibrosis.