Sputum is a pathological discharge from the lungs and respiratory tract(bronchi, trachea, larynx). Clinical analysis of 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 in acute bronchitis, pneumonia, stagnation 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 drainage disturbance 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 greenish tint, which can be observed with a lung abscess, bronchiectasis. When there is an admixture of fresh blood 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 released during various pathological processes in the lungs, combined with the presence of jaundice in patients, may have a dirty green or yellow-green color. 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 violation of the outflow of sputum. Putrid smell, it acquires with an abscess, gangrene of the lung, with putrefactive bronchitis as a result of the addition of 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, and 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 in chronic processes and at the stage of resolution acute processes in the bronchopulmonary system.
Columnar ciliated epithelial cells – 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 sputum, it does not have 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, and pulmonary infarction. Lymphocytes are found in large numbers 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.

Sputum for general clinical research It is recommended to collect in the morning and on an empty stomach, during a coughing attack, in a sterile plastic container. With a purpose mechanical removal food debris and desquamated epithelium are sanitized before coughing oral cavity- 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

Determination method bacteriological, bacterioscopic

Material under study Sputum, bronchial or tracheal washings

Bacteriological diagnosis of infectious lesions of the respiratory tract and rationale for rational antibiotic therapy.

Diagnosis and treatment of pulmonary pathology is based on many special methods research. The most important of them is the microbiological method. It is necessary for the differential diagnosis of pneumonia (pneumococcal, staphylococcal, streptococcal, etc.), lung abscess, chronic obstructive pulmonary diseases, bronchiectasis. Only a microbiological diagnosis can truly be substantiated rational therapy and heal the sick.

Isolated pathogens: etiologically significant - H. influenzae, S. pneumoniae and M. catarrhalis, gram-negative bacteria of the Enterobacteriaceae family, P. aeruginosa, S. aureus (including MRSA), S. pyogenes, Acinetobacter sp., fungi of the genus Candida.

Sputum, passing through the upper respiratory tract and oral cavity, can be contaminated by microflora vegetating in them, these can be viridans streptococci (S. viridans group), staphylococci (S.epidermidis), non-pathogenic neisseria (Neisseria sp.), non-pathogenic diphtheroids (Corynebacterium sp. .), Lactobacillus sp., Candida sp. and some others.

Please note that it is necessary to purchase a sterile container for collecting sputum or other biological fluids, which we recommend purchasing in advance at any INVITRO medical office with a deposit. Deposit funds are returned upon completion of the analysis and subject to a receipt for the deposit.

Literature

1. Bercow R. (Ed.). Guide to medicine, vol. I M. "Mir", 1997. 1045 p.
2. Order of the USSR Ministry of Health dated April 22, 1985 No. 535 On the unification of microbiological (bacteriological) research methods used in clinical diagnostic laboratories of medical institutions.
3. Encyclopedia of clinical laboratory tests edited by WELL. Titsa. Publishing house "Labinform" - M. - 1997 - 942 p.
4. Nightingale C. et al./ Antimicrobial Pharmacodynamics in Theory And Clinical Practice/2006/ M.Dekker inc./ 550 ps.

Biomaterial: Sputum

Completion time (in the laboratory): 1 w.d. *

Description

Sputum is a pathologically altered tracheobronchial secretion released when coughing, released in diseases of the lungs and respiratory tract.

General clinical examination of sputum includes a description of its general properties and microscopic examination of native and stained preparations. The study determines the following indicators: the amount of sputum, its color, smell, reaction and character, alveolar macrophages, ciliated epithelial cells, squamous epithelium, leukocytes, erythrocytes, elastic fibers, coral fibers, calcified fibers, Courchmann spirals (consisting of mucus), Charcot-Leyden crystals (formed by the breakdown of eosinophils, consisting of proteins), cholesterol and hematoidin crystals, actinomycete drusen, elements of echinococcus, Dietrich's plugs (detritus with bacteria, needles fatty acids, drops of neutral fat), spherules and mycelium of fungi, larvae of roundworms and intestinal eels, lung fluke eggs, atypical cells.

Sputum is a pathologically altered tracheobronchial secretion released when coughing, released in diseases of the lungs and respiratory tract. General clinic

Indications for use

• Acute and chronic bronchitis,
• Pneumonia,
• Tuberculosis,
• Oncological diseases.

Preparing for the study

No special preparation is required for the study. Sputum should be collected in the morning before meals. To prevent oral contents from mixing with sputum, before releasing sputum, thoroughly brush your teeth and rinse your mouth and throat with boiled water. Only sputum produced by coughing should be collected, not expectoration.

Interpretation of results/Information for specialists

The volume of sputum produced is small when acute bronchitis, bronchial asthma, increased - with abscess, gangrene, pulmonary tuberculosis.

The color is determined by the composition of the sputum: rusty - when lobar pneumonia(decomposition of red blood cells), yellow - due to large quantity eosinophils, greenish - with stagnation of purulent sputum, black - the presence of coal dust.

Freshly secreted sputum is usually odorless. A putrid odor is characteristic of purulent diseases: abscess and gangrene of the lungs.

Based on consistency, sputum is divided into liquid, thick and viscous. The nature of sputum reflects the course pathological process: mucous membrane is colorless, viscous observed in asthma, purulent sputum is possible with the opening of pleural empyema, abscess and gangrene of the lung. Mucopurulent sputum is released when bacterial pneumonia and purulent bronchitis. With pulmonary edema, serous sputum is released - transparent, liquid. Sputum containing clots and streaks of blood is observed in acute or chronic bronchitis, pneumonia, abscess, lung cancer, bronchiectasis, tuberculosis.

Under microscopy, an increased number of eosinophils indicates bronchial asthma and other allergic diseases, helminthic infestation, unchanged red blood cells are characteristic of pulmonary infarction. Kurshman spirals are found in bronchial asthma, abscesses and lung tumors. Elastic fibers are characteristic of destructive changes in the lungs, and coral fibers - in cavernous tuberculosis. Charcot-Leiden crystals are characteristic of bronchial asthma and allergic conditions. Dietrich's plugs, characteristic of lung abscess and bronchiectasis, are found in purulent sputum. Detection of atypical cells requires clarification of the tumor diagnosis using other diagnostic methods.

Most often ordered with this service

Code	Name	Term	Price	Order
		from 1 w.d.	370.00 rub.
		from 1 w.d.	230.00 rub.
		from 4 days	1280.00 rub.

Sputum culture

Bacteriological research sputum (sputum culture) - a test to identify pathogenic microorganisms, which cause infectious diseases of the bronchopulmonary...

Average price in your region: 707.4 from 400... to 845

25 laboratories make this analysis in your region

Description of the study

Preparing for the study:- Sputum must be collected in a special sterile container (issued in the laboratory).

Sputum collection is carried out in the morning on an empty stomach.

Sputum is collected before starting antibacterial therapy.

Before collecting sputum, the patient must brush his teeth and rinse his mouth. boiled water to remove food debris and oral microflora.

Sputum is collected during a coughing attack (if sputum is difficult to separate, you must first take an expectorant).

The collected biomaterial must be delivered to the laboratory within 1 - 1.5 hours. Sputum can be stored for 2 hours at room temperature, 5-6 hours at a temperature of 2-8°C. Test material: Sputum

Bacteriological examination of sputum (sputum culture) - a study that allows identifying pathogenic microorganisms that cause infectious diseases bronchopulmonary system.

Sputum is a secretion secreted from the bronchi and trachea during coughing, the appearance of which usually indicates serious illnesses lower respiratory tract (bronchitis, pneumonia, lung cancer, pulmonary tuberculosis, pulmonary edema, etc.). Using sputum culture, the causative agent of the corresponding disease is determined.

Microbial cultures most often isolated during bacterial research sputum: Streptococcus pneumoniae, Strephylococcos aureus, Micrococcus, Neisseria, Haemophilus influenzae, Listeria monocytogenes, Corynebacterium sp., Klebsiela, Pseudomonus aerusinosa, E. Coli, Citrobacter sp., Profeus sp., Actinomyces. If atypical pneumonia or tuberculosis is suspected, the bacteria that cause them - Chlamydia psittaci and Mycobacterium tuberculosis - can be identified using special media and methods.

The analysis allows us to evaluate the composition bacterial microflora in sputum - a pathological secretion formed in certain diseases of the respiratory system. The analysis helps to identify the cause of such diseases.

Method

Bacteriological method. The method involves “growing” colonies of microorganisms on a nutrient medium into which the test material (sputum) is placed. Meat-extract broth, agar, gelatin with the addition, in some cases, of blood, whey or carbohydrates are used as nutrient media. In such favorable conditions bacteria and microscopic fungi begin to actively multiply, which greatly facilitates their identification and counting.

Reference values ​​- norm
(Sputum culture for microflora)

Information regarding the reference values ​​of indicators, as well as the composition of the indicators included in the analysis, may differ slightly depending on the laboratory!

Norm:

Normally, representatives can be found normal microflora upper respiratory tract: Streptococcus gr.Viridans, Corynebacterium spp., Neisseria spp., Staphylococcus spp. etc.

The detection of only normal microflora does not indicate the absence of infection.

In immunocompromised patients, the amount of normal microflora may significantly exceed normal values. In this case, such flora is considered pathogenic and is considered as a causative agent of infection.

Indications

The analysis is prescribed for diseases of the bronchopulmonary system (pneumonia, bronchitis, lung abscess, pulmonary tuberculosis, etc.) to clarify the diagnosis and identify the causative agent of the infection.

Increasing values ​​(positive result)

In diseases of the bronchopulmonary system, the following microorganisms can be detected:

Pathogenic microorganisms high level priority - Streptococcus pneumoniae, Haemophilus influenza, Staphylococcus aureus, Klebsiella pneumoniae.

Medium priority pathogenic microorganisms are Enterobacteriaceae, Branhamella catarrhalis.

Pathogenic microorganisms low level priority: Pseudomonas aeruginosa, Legionella pneumophila, Mycoplasma pneumoniae, Chlamydia spp.

> Culture of sputum and tracheobronchial washings for microflora with determination of its sensitivity to antimicrobial drugs and smear microscopy

This information cannot be used for self-medication!
Consultation with a specialist is required!

Why is sputum culture needed, and what are tracheobronchial washings?

Culture of sputum and tracheobronchial washings is a bacteriological method for diagnosing a number of infectious diseases respiratory tract. Culture has two main goals: identifying the main causative agent of the disease and determining rational tactics of antibiotic therapy.

Sowing is carried out by placing sputum or swabs on a special nutrient medium on which active growth of microorganisms occurs, if they are present in the samples. By the nature of the growth of colonies, you can understand which microorganism was the causative agent of the disease. Placing on grown colonies antimicrobials, determine the sensitivity of microbes to them.

Tracheobronchial washes are one of the ways to obtain secretions from the trachea and bronchi. They are used when sputum is poorly secreted to obtain biological material for the purpose of inoculating it on nutrient media. The principle of the method is to insert into the trachea small amount sterile solution and then collecting it back for analysis.

What is the essence of smear microscopy?

During smear microscopy, biological material is examined under a microscope. The preparations are pre-stained with dyes using special technologies (Gram, Romanovsky-Giemsa, etc.). Bacteria various types have specific type and coloring, which allows for a more accurate diagnosis.

Who sends sputum and swabs for culture, where is it donated?

A therapist, pulmonologist, or phthisiatrician can refer you for this examination. Sputum can be collected in a microbiological laboratory or in a specialized department where the patient is undergoing treatment.

How to prepare for sputum donation, the procedure for collecting tracheobronchial swabs

It is better to take tests on an empty stomach; you should not smoke before the procedure. Collecting sputum is quite simple: the patient coughs and spits the sputum into a plastic container.

The simplest way to obtain tracheobronchial lavage is to simultaneously inject 10 ml of sterile saline into the trachea using a laryngeal syringe. This causes a cough. The coughed up liquid is collected in a container. Less commonly, washings are obtained using bronchoscopy.

When is examination of sputum and bronchial washings indicated?

This study is prescribed for purulent-inflammatory diseases of the respiratory tract, which include pneumonia, bronchitis, abscess and gangrene of the lung, tuberculosis, and chronic bronchiectasis.

Patients with these diseases complain of general malaise, fever, cough, shortness of breath, and a feeling of lack of air. IN general analysis In the blood, leukocytosis is noted with a shift of the leukoformula to the left, and the ESR increases.

Interpretation of results, clinical significance of the examination

The results of the examination are of interest to the treating doctor. He interprets them taking into account clinical picture disease and data from other examination methods, such as x-rays of organs chest, bronchoscopy.

In conclusion, the laboratory doctor provides information about the presence or absence of microflora growth in the culture, the number of bacterial colonies grown, and their species. It indicates the sensitivity of bacteria to antibiotics. List of specific antibacterial drugs determined by the type of microorganisms detected.

During microscopy of smears, the shape and appearance of all microorganisms are described and a conclusion is drawn about their species. Normally, leukocytes and epithelial cells may be present in the smear.

The significance of this examination is to determine the specific causative agent of the disease, which makes it possible to prescribe the most effective antibiotics.