Sputum culture for microflora. Culture of sputum and tracheobronchial swabs for microflora with determination of sensitivity to antimicrobial drugs and smear microscopy Submit sputum for in vitro analysis

Sputum called a pathological mixture of secretions from the mucous membranes of the nasal cavity, paranasal sinuses, tracheobronchial region respiratory tract and saliva secreted during expectoration.

Appearance sputum in a child indicates pathology of the respiratory system:

viral disease;
pneumonia;
bronchitis;
neoplasms;
tuberculosis;
bronchial asthma;
abscess or pulmonary edema;
foreign body in the respiratory tract.

It is possible to accurately diagnose a problem in a child’s lungs or bronchi using microbiological examination of sputum, allowing us to establish the nature of the pathogenic process and its origin. Sputum analysis allows the child to detect:

pathogenic microbes - pathogens infectious lesions respiratory organs;
helminthic or fungal infestation of the lungs;
pathological components sputum - blood, serous fluid, pus, atypical cells;
the susceptibility of pathogenic microorganisms to antibacterial and antimicrobial agents, which allows for timely rational treatment and prevents the disease from becoming chronic.

When is a sputum test done?

sustainable prolonged cough with the release of pathological secretion;
high temperature;
enlarged lymph nodes;
general malaise.

How is the analysis carried out?

It is important to take into account the fact that sputum accumulates in the respiratory tract at night, and its collection is best done in the morning - before breakfast. Biological material must be collected in a special sterile container, purchased in advance from a pharmacy. To obtain accurate research results the child needs:

Drink plenty of warm liquid the night before.
Perform a thorough toilet in the morning oral cavity.
Swallow saliva, inhale deeply through your mouth.
Cough vigorously, the volume of biomass should be 3-5 ml.
Deliver sample to laboratory center no later than two hours after collection.

Important Do not allow saliva or mucus from the nasal cavity and pharynx to get into the sample!

If a weakened child cannot cough on his own, the discharge sputum caused by irritation of the root of the tongue with a sterile swab. Sputum, which has fallen on the swab, is applied in a thin layer to a glass slide, dried and delivered for examination.

In laboratory conditions sputum exposed to:

macroscopic study- its color, quantity, consistency, smell, transparency are determined;
microscopic examination- study of various impurities, cellular elements, and microflora composition in native and colored preparations;
microbiological analysis- determination of the probable causative agent of the pathological process using bacteriological culture.

Analysis transcript

In custody sputum examination information is provided characterizing:

physical properties;
microscopic picture - the number of epithelial cells (>25 in the field of view) and leukocytes (>10 in the field of vision) is of diagnostic importance;
absence or presence of growth of saprophytic bacteria - titer >105 CFU/ml is of etiological significance;
genus and species of microflora;
susceptibility of microorganisms to antibiotics.

Antibiotic sensitivity testing of sputum is a test that allows you to identify pathogenic microorganisms, causing infectious diseases bronchopulmonary system.

The study requires a sputum culture tank for microflora. Sputum (pathological secretion) is released from the trachea and bronchi during coughing. Its appearance indicates respiratory diseases.

The composition of sputum is heterogeneous. It may contain mucus serous fluid, pus, fibrin, blood.

Using sputum culture, the causative agent of the corresponding disease and its sensitivity to antibiotics are determined. This makes it possible to assign correct treatment, preventing the disease from becoming chronic.

When is a test ordered?

IN mandatory the doctor orders a sputum test

for tuberculosis
on bk
for bronchitis
for pneumonia
for bronchial asthma
for neoplasms of the respiratory system
helminthic, fungal invasion of the lungs.

Also, bacteriological analysis of sputum is carried out in case of unclear processes in chest according to the results X-ray examination or auscultation.

Normally, sputum analysis can show the presence of representatives normal microflora. However, the detection of only normal microflora does not mean the absence of infection.

Deciphering and interpretation of the study results is carried out only by the attending physician. As a rule, the sputum contains microflora of the oropharynx, so the culture result is interpreted taking into account the general standing of the patient and clinical picture.

Sputum collection

To make the results more accurate, you need to correctly collect sputum for analysis. Sputum accumulates at night, so it should be collected in the morning before meals after rinsing the mouth. boiled water.

It should be noted that more sputum is produced, and it is better removed if you drink more liquid before the test. To make sputum testing more effective, the patient must do three deep breaths and cough vigorously.

The material is collected in a disposable, sterile, impact-resistant container with a tight-fitting lid.

A general analysis of sputum provides a macroscopic assessment of the secretion (consistency, color, presence, nature of impurities), as well as its microscopy. Sputum microscopy evaluates the cellular composition, the presence of crystals, fibers, and microflora. This test does not diagnose specific diseases, for example, tuberculosis.

Why research is needed

Sputum examination is used:

in the diagnosis of pathological processes in the respiratory tract and lungs;
to assess the nature of pathologies;
to monitor the dynamics of the condition of a patient with chronic diseases;
to assess the effectiveness of the treatment.

INVITRA laboratory will conduct necessary research, including sputum analysis for microflora in short time using modern equipment that allows you to draw the most accurate conclusions.

Represents microbiological examination discharge from lower sections respiratory tract to determine the type of microorganism and select adequate therapy. Main indications for use: inflammatory diseases respiratory tract (pneumonia, acute and chronic bronchitis, lung abscess). Typically, sputum is obtained by coughing or tracheal aspiration.

Pathogens of lower respiratory tract infections are divided into three groups according to the degree of pathogenicity:

Pathogens high level priority - Staphylococcus aureus, Haemophilus influensae, Klebsiella pneumoniae, Streptococcus pneumoniae.
Medium level - Candida albicans, Moraxella (Branhamella) cataralis, enterobacteria.
Low pathogenic - Mycoplasma pneumonia, Pseudomonas aeruginosa, Chlamydia spp., Legionella pneumophila and a number of other microorganisms.

When interpreting the data obtained, it should be taken into account that in persons with reduced immunity, representatives of the normal flora in quantitative terms can significantly exceed their normal values and in this case, this flora is considered as the causative agent of infection. It is believed that for sputum clinically significant number is 106-107 CFU/ml. For bronchial washings after bronchoalveolar lavage - 104-105 CFU/ml.

Digital values of contamination units are interpreted as follows: for example, bacteria 102 were detected, which means that 100 colony-forming units of bacteria were detected in 1 ml biological material, since the degree number (in this example it is number 2) indicates the degree of contamination. If 103, then 1000 colony-forming units of bacteria in 1 ml of biological material.

Due to the fact that sputum usually contains oropharyngeal microflora, the culture result should be interpreted taking into account the clinical picture and general condition patient.

Bacteria leading to the development of respiratory tract pathology include Staphylococcus aureus, Haemophilus influenzae, Pseudomonas aeruginosa, Streptococcus pyogenes, Streptococcus pneumoniae, Moraxella catarrhalis, fungi of the genus Candida, Nocardia asteroides and N. cavia, Acinetobacter baumannii, Chlamydia psittaci and Mycobacterium tuberculosis - 100 %.

Norms

Normally, human sputum is contaminated (contaminated) with the following types of normal symbiotic microflora characteristic of the upper respiratory tract: Staphylococcus spp., Streptococcus viridans group., Corynebacterium spp. (with the exception of Corynebacterium diphtheria), Neisseria spp. (except Neisseria meningitidis), Bacteroides spp., Veillonella spp., Lactobacillus spp., Candida spp., Diphtheroids, Fusobacterium spp.

Sputum– this is a pathological discharge of the lungs and respiratory tract (bronchi, trachea, larynx). Clinical analysis sputum includes a description of its nature, general properties and microscopic examination.

General properties:

Amount of sputum usually ranges from 10 to 100 ml per day. A small amount of sputum is released when acute bronchitis, pneumonia, congestion in the lungs, at the beginning of an attack bronchial asthma(at the end of the attack its quantity increases). A decrease in the amount of sputum discharge during suppurative processes in the lungs may be a consequence of subsidence, as inflammatory process, and as a result of impaired drainage of the purulent cavity, which is often accompanied by a deterioration in the patient’s condition. A large amount of sputum can be released during pulmonary edema, as well as during suppurative processes in the lungs (with an abscess, bronchiectasis, gangrene of the lung, with a tuberculous process accompanied by tissue decay). An increase in the amount of sputum can be regarded as a sign of deterioration of the patient’s condition if it depends on the suppurative process; in other cases, when an increase in the amount of sputum is associated with improved drainage of the cavity, it is regarded as a positive symptom.

Sputum color. More often, sputum is colorless; the addition of a purulent component gives it a greenish tint, which can be observed with a lung abscess or bronchiectasis. When an admixture of fresh blood appears in the sputum, the sputum turns into various shades of red (sputum during hemoptysis in patients with tuberculosis, lung cancer, lung abscess, pulmonary edema, cardiac asthma). Rust-colored sputum (with lobar, focal and influenza pneumonia, pulmonary tuberculosis, pulmonary congestion, pulmonary edema). Sputum may be dirty green or yellow-green in color and may be discharged at different times. pathological processes in the lungs, combined with the presence of jaundice in patients. Blackish or grayish sputum is observed when there is an admixture of coal dust and in smokers. Some medications can also stain sputum.

Smell. Sputum is usually odorless. The appearance of odor is usually caused by a disturbance in the outflow of mucus. It acquires a putrid odor with an abscess, gangrene of the lung, with putrefactive bronchitis as a result of the addition of a putrefactive infection, bronchiectasis, lung cancer complicated by necrosis. An opened hydatid cyst is characterized by a peculiar fruity smell of sputum.

Character of sputum

Mucous sputum is released during acute and chronic bronchitis, asthmatic bronchitis, tracheitis.
Mucopurulent sputum is characteristic of abscess and gangrene of the lung, purulent bronchitis, staphylococcal pneumonia.
Purulent-mucous sputum is characteristic of bronchopneumonia.
Purulent sputum is possible with bronchiectasis, staphylococcal pneumonia, abscess, pulmonary actinomycosis, gangrene.
Serous sputum is detected with pulmonary edema.
Serous-purulent sputum is possible with a lung abscess.
Bloody sputum is released during pulmonary infarction, neoplasms, lung injury, actinomycosis and syphilis.

Cells:
Alveolar macrophages. Large amounts in sputum are detected when chronic processes and at the resolution stage acute processes in the bronchopulmonary system.
Cylindrical cells ciliated epithelium – cells of the mucous membrane of the larynx, trachea and bronchi; they are found in bronchitis, tracheitis, bronchial asthma, malignant neoplasms.
Flat epithelium detected when saliva enters the sputum, it has no diagnostic value.
Leukocytes may be present in sputum in any quantity. A large number of neutrophils are detected in mucopurulent and purulent sputum. Sputum is rich in eosinophils in bronchial asthma, eosinophilic pneumonia, helminthic lesions of the lungs, pulmonary infarction. Lymphocytes in large quantities found in whooping cough and, less commonly, in tuberculosis.
Red blood cells . Detection of single red blood cells in sputum has no diagnostic value. In the presence of fresh blood, unchanged red blood cells are detected in the sputum.
Cells malignant tumors found in malignant neoplasms.

Fibers
Elastic fibers appear during decay lung tissue which is accompanied by the destruction of the epithelial layer and the release of elastic fibers; they are found in tuberculosis, abscess, echinococcosis, and tumors in the lungs.
Coral fibers are detected when chronic diseases(cavernous tuberculosis).
Calcified elastic fibers – elastic fibers impregnated with calcium salts. Their detection in sputum is characteristic of tuberculosis.

Spirals, crystals
Kurshman spirals are formed due to the spastic condition of the bronchi and the presence of mucus in them; characteristic of bronchial asthma, bronchitis, lung tumors.
Charcot-Leyden crystals - eosinophil breakdown products. Characteristic of bronchial asthma, allergic conditions, eosinophilic infiltrates in the lungs, pulmonary fluke.
Mycelium and budding cells of fungi appear with fungal infections of the bronchopulmonary system.
Mycobacterium tuberculosis. The detection of Mycobacterium tuberculosis in sputum indicates tuberculosis damage to the lungs or bronchi.

It is recommended to collect sputum for general clinical examination in the morning and on an empty stomach, during a coughing attack, in a sterile plastic container. In order to mechanically remove food debris and desquamated epithelium, before coughing, the oral cavity is sanitized - the patient brushes his teeth, rinses his mouth and throat with boiled water. In case of poorly separated sputum, it is recommended to prescribe expectorants and warm drinks the day before