Discussions
Discussions
oropharyngeal flora in sputum sample
I have repeatedly submitted sputum samples and gotten the following response "The presence of 10 or more epithelial cells per low power field
indicates contamination with oropharyngeal flora making the specimen
unsuitable for processing." Why is this happening and what can I do about how I collect the sample to avoid having it contaminated? My pulmonologist told me it happens often and not to worry, but those samples aren't being evaluated for gram stain cultures which have revealed infections (not NTM's) in the past.
Thanks for anyone who has advice they can share.
Replies
My not-a-doctor thought is that upper level sputum and bacteria from your mouth / throat / pharynx are interfering with testing. The best solution might be to try to go deeper so it's only (or mostly) lung gunk. Options include using airway clearing devices or techniques before giving the sample, or try huff coughing right before (videos on youtube). Avoid spitting into the cup, if possible, since that could mostly be mouth spit. Or get some extra sample cups from your doctor or a lab. Give three samples, but only send in the one with the thickest gunk. If that fails, maybe try a different lab? Good luck!
Hi everyone! I am new to this forum. I agree with marsrocket. I submit my sputum sample to NYU Langone lab and it seems as thought they have becoming more picky about the quality of the samples over the years. I understand it because they don't want to report out a bug that is an okay bug for the mouth as being in the lungs (perhaps not so ok).
I am not a very mucus-productive person so I often skip a day of airway clearance prior to my sputum sample day. That helps to build up a little more of the deep stuff. If this still doesn't work for you, depending on the hospital, you can ask your doctor to order an induced sputum. I haven't needed one, yet, but I believe the therapist has you nebulize 10% hypertonic saline and then they further assist you to produce a sample.
Comments
A few years ago I had bronchoscopy and the took a sample and a week later they said was normal flora. As of sputum sample from Dec said I had yeast. Will be discussing this in April as nothing more was said on the results. I cant take diflucan so not sure if anything will be done.
Hello! The labs definitely are more selective with sputum specimens over the past few years.
I never received “ reject lab “notes previously. I assume that the lab separated what was in the cup . They must be receiving a lot more sputum samples and this new procedure makes it easier for the lab and it provides better, more accurate results for patients?
Marsrocket,
Thank you for the reminder of brushing our teeth or finding before giving a sputum sample.
You're welcome, Katie. If at a doctor's office could at least do some mouth rinsing.
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