Screening Sputum Specimens for Mycobacterial Culture

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Abstract
We investigated whether the rejection policy used in our laboratory for sputum specimens submitted for routine bacterial culture could be applied to sputum specimens submitted for mycobacterial culture. We compared the quality of sputum specimens, based on quantity of polymorphonuclear leukocytes and squamous epithelial cells observed in a Gram-stained smear, with mycobacterial culture results. Of the 391 specimens evaluated, 173 (44.2%) would have been rejected by our criteria. A mycobacterium was recovered from 42 (24.3%) of these specimens. Of the 218 specimens that would have been accepted, 66 (30.3%) grew a mycobacterium. We concluded that our policy for rejection of sputum specimens submitted for routine bacterial culture should not be applied to those submitted for mycobacterial culture, unless it is possible to timely collect a subsequent sample from patients whose initial specimen is found to be contaminated with saliva.

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