Sputum Culture

Test Overview

Sputum is a thick fluid made in the lungs and in the airways leading to the lungs. A sputum culture is a test to find germs (such as bacteria or a fungus) that can cause an infection. A sample of sputum is added to a substance that promotes the growth of germs. If no germs grow, the culture is negative. If germs that can cause infection grow, the culture is positive. The type of germ may be identified using a microscope or chemical tests. Sometimes other tests are done to find the right medicine for treating the infection. This is called sensitivity testing.

You may be asked to cough to provide the sputum sample. Some people can't cough deeply enough to produce a sample. They can breathe in a special mist to help them cough.

Why It Is Done

A sputum culture is done to:

• Find bacteria or fungi that are causing an infection of the lungs or the airways leading to the lungs. Examples include pneumonia and tuberculosis. Symptoms of a lung infection may include having a hard time breathing, pain when breathing, or a cough that produces bloody or greenish brown sputum.
• Find the best antibiotic to treat the infection. (This is called sensitivity testing.)
• See if treatment is working.

How To Prepare

Do not use mouthwash before you collect your sputum sample. Some types of mouthwash can kill bacteria and could affect your results.

If bronchoscopy will be used to collect your sputum sample, your doctor will tell you how soon before the test to stop eating and drinking. Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.

Tell your doctor if you have recently taken antibiotics.

How It Is Done

In most cases, the sputum sample is collected soon after you wake up before you eat or drink anything. In some cases, three or more samples may be needed on three or more separate days. (This is often done if you may have tuberculosis.)

If you wear dentures, you will need to take them out before you collect your sputum sample. Then rinse your mouth with water. Next, take a deep breath and cough deeply to get a sample of sputum. If you are having trouble coughing up a sample, you may be asked to inhale an aerosol mist to help you cough.

Bronchoscopy

Some people may need bronchoscopy to collect a sputum sample. A thin, lighted tube (bronchoscope) is put through your mouth or nose into the airways leading to your lungs. You will get medicine that numbs your throat and nose so you do not feel pain from the bronchoscope. You may also get sedation or general anesthesia. To collect the sample, a salt solution may be washed into the airway and then suctioned into a container. A small, thin brush may be used to collect a sample.

Suction

Suction can also be used to collect a sputum sample. A soft, flexible tube (called a nasotracheal catheter) is put through the nose and down the throat. Suction is applied for up to 15 seconds to collect the sample. This method is often used for people who are very sick or unconscious.

How long the test takes

• The test will take a few minutes.

How It Feels

If you have discomfort when taking a deep breath or coughing, getting a sputum sample may feel uncomfortable. If you need to inhale the aerosol mist, you will likely feel a strong urge to cough.

During a bronchoscopy (the collection of a sputum sample using a thin, lighted tube called a bronchoscope) you may feel pressure in your airway as the tube is moved. You may gag or cough. But if you have general anesthesia, you will feel nothing during the procedure.

Risks

There is very little chance of having a problem when you provide a sputum sample at home or in the doctor's office. A bronchoscopy is also a generally safe procedure. Problems are rare, but discuss the risks in your particular case with your doctor.

Results

Some types of bacteria or fungi grow quickly in a culture. Others grow slowly. Test results may take from 1 day to several weeks. How long your results take depends on the type of infection your doctor thinks you may have. Some organisms don't grow in a standard culture and need a special growth medium to be found in a sputum culture.

Sputum culture

Normal:	Sputum that has passed through the mouth normally contains several types of harmless bacteria. These include some types of strep (Streptococcus) and staph (Staphylococcus). The culture should not show any harmful bacteria or fungi. Normal culture results are negative.
Abnormal:	Harmful bacteria or fungi are found. The most common harmful bacteria in a sputum culture are those that can cause bronchitis, pneumonia, or tuberculosis. If harmful bacteria or fungi grow, the culture is positive.

If test results point to an infection, sensitivity testing may be done. This testing helps to find the best antibiotic to kill the bacteria or fungus.

Even if your culture does not grow any bacteria or fungi, you may still have an infection.