SPUTUM SPECIMEN GUIDELINES AND CULTURE

Collecting a sputum specimen involves obtaining a sample of mucus and other respiratory secretions from the lower respiratory tract. This type of specimen is often used to diagnose respiratory infections, identify the presence of bacteria or fungi, and assess the effectiveness of treatment.

Here’s a general guide on collecting a sputum specimen:

1. Timing:
   • Collect the sputum sample in the morning, if possible, as the respiratory secretions are usually more concentrated at this time.
2. Patient Preparation:
   • Rinse your mouth with water to reduce contamination of the specimen with oral bacteria.
   • Take deep breaths to help bring up sputum from the lower respiratory tract.
3. Collection Technique:
   • Cough deeply to produce sputum from the lungs.
   • Spit the sputum directly into a sterile, screw-capped container provided by the healthcare facility.
   • If the sputum is difficult to produce, inhaling steam or using a nebulizer with a saline solution may help.
4. Avoid Contamination:
   • Minimize saliva contamination by making sure the sputum comes from the lungs, not the oral cavity.
5. Quantity:
   • Collect an adequate amount of sputum (usually about 5-10 mL) to ensure accurate testing.
6. Labeling:
   • Label the container with your name, date of collection, and any other information required by your healthcare provider.
7. Transport to the Laboratory:
   • Deliver the sputum specimen to the laboratory as soon as possible after collection.
   • If immediate delivery is not possible, store the specimen in the refrigerator to prevent bacterial overgrowth.
8. Documentation:
   • Document any relevant symptoms, such as coughing, shortness of breath, or fever, that may assist in the interpretation of test results.
9. Special Instructions:
   • Some tests may require additional instructions, such as collecting multiple samples over consecutive days or following specific treatment protocols. Follow any guidelines provided by your healthcare provider.
10. Preservation Solutions:
    • Your healthcare provider may provide a preservative solution to mix with the sputum sample. Follow the instructions for using any provided solutions.

SPUTUM CULTURE

Collection of coughed out sputum for culture studies to identify respiratory pathogens

Purpose

• To detect abnormalities
• To diagnose disease condition
• To detect the microorganisms causes respiratory tract infections
• To treat with specific antibiotics

Characteristics of Sputum

• Quantity: normally, no sputum is expectorated the amount of sputum coughed up in 24 hours varies with the diseases
• Consistency: the sputum may be classified into various types according to its consistency and appearances, e.g. serous, frothy, mucoid, purulent, seropurulent and hemorrhagic
• Odor: normally the sputum is odorless in case of lung abscess; carcinoma and bronchiectasis the sputum will bed foul smelling
• Color: sputum consists of mucus it may be:

Colorless and translucent

Yellowish color – presence of pus

Blackish sputum – excessive smoking

Blood – hemoptysis

Red and frothy sputum – freshly bleeding from lungs

Rusty color – altered hemoglobin as seen in pneumonia

Greenish color – bronchiectasis

Brown color – gangrenous condition of the lungs

• If sputum examined microscopically, a few WBC and epithelial cells may be seen. Eosinophils are found in such conditions as asthma. RBC is found only when there is hemoptysis. The main organism that is looked for in stained sputum is tubercle bacilli (AFB)

General Instructions

• Give water proof disposal sputum mug on the previous evening and instruct to raise the material from the lungs by coughing and not the saliva
• Collect the sputum in the morning
• Ask the patient to rinse the mouth with plain water. Do not use any antiseptic mouth washes
• If sterile specimens are required sterile bottle with cover is given to the patient

Preliminary Assessment

Check

• The doctors order for specific instructions
• General condition and diagnosis of the patient
• Self-care ability
• Mental status to follow instructions
• Articles available in the unit

Preparation of the Patient and Environment

• Explain the procedure to the patient
• Arrange the articles at the bedside
• Provide privacy if needed

Equipment

• Sterile sputum container
• Sputum mug or cup
• Tissue paper
• K-basin

Procedure

• Instruct to collect specimen early morning before brushing teeth, to obtain overnight accumulated secretions
• Instruct to remove and place lid facing upward
• Instruct not to contaminate inside of lid and container, as well as outside of container
• Instruct to cough deeply and expectorate directly into specimen container
• Collect at least 10 ml of sputum
• Close the container immediately sputum is collected

After Care

• Label the container with patients name date and hospital number
• Send specimen to laboratory immediately along with request
• Replace the equipment after cleaning
• Wash hands thoroughly
• Record the procedure in nurse’s sheets