Ideal Sputum Specimen: Introduction, Selection and Rejection Criteria

Gram stain indicating Ideal sputum i.e Sputum Specimen quality determination prior to culturing: Introduction and rejection criteria

Introduction of Ideal Sputum Specimen

Prior to culturing a sputum specimen, a gram stain is necessary to perform to evaluate the quality of the specimen whether smear is ideal or not.

One of the most common criteria is currently using to determine whether the specimen is contaminated with oral flora organisms or upper respiratory tract flora, which would make the specimen unsuitable for culture.

This criterion states that the sputum specimen will reject when more than 10 epithelial cells/low power field (LPF) and pus cells less than 25/low power field (LPF) are observing while the specimen will accept for observation at oil immersion field and culturing if less than 10 epithelial cells/low power field (LPF) and pus cells greater than 25/low power field (LPF) are observing and this type sputum is also called ideal sputum.

The low power microscopic field is representative of 20 microscopic fields that were reviewed on this Gram-stained preparation of sputum. This specimen would consider acceptable for culture.

What to do in rejection criteria?

If the specimen falls under the rejection criterion, the clinician should contact and request should make for a new specimen. It is important to communicate that culturing the specimen provided will not yield useful information about the possible pathogens from the lower respiratory tract.

When the specimen is determined to be a good quality lower respiratory tract specimen, continue to examine the slide under oil immersion magnification for bacteria, yeast, and polymorphonuclear cells (PMNs) also called pus cells, and proceed with culturing the specimen.

Report

From the image, Gram stain report:
Pus cells greater than 25/LPF
Epithelial cells less than 10/LPF
Few Gram-Negative bacilli seen

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