Respiratory Culture for Sputum, Tracheal Aspirates, and Bronchial Alveolar Lavage (BAL) – Bacterial Examination
POWERCHART ORDER – Sputum Culture, Respiratory Culture, Respiratory Culture (Bronchial Brushings), Respiratory Culture (Bronchial Washings),Respiratory Culture (Sputum),Respiratory Culture (Trachial Aspirate)
Useful For
Lower respiratory tract specimens include expectorated sputum, suction material (luki specimens), bronchial washings, and trans-tracheal aspirates, are obtained to determine the etiology of a pneumonia. However, a sputum culture is a very insensitive technique that often fails to recover the offending pathogen. Therefore, pneumonias are usually treated based on the clinical setting and current clinical status using broad spectrum antibiotics that are NOT chosen on the basis of culture or gram stain results.
The purpose of a sputum culture is to allow antibiotic coverage to be narrowed. This can only be done when ONE organism is predominant and seen on smear in the presence of neutrophils. Many patients, especially those who are intubated or have pulmonary disease (COPD, emphysema, cystic fibrosis, etc.) may be benignly colonized with potential lung pathogens.
Method Name
Culture
Aliases
Sputum Culture; Lower Respiratory Culture; Sputum C&S, Sputum Culture,Respiratory Culture, C Resp
Specimen Type
Specimen types accepted for lower respiratory cultures include:
- Expectorated sputum (obtained by collecting the products of a deep cough in a sterile container).
- Induced sputum (obtained by a respiratory therapist, using a nebulizer to induce coughing).
- Suctioned sputum or tracheal secretions (luki specimens)
- Bronchial washings or brushings (obtained by physician via special procedure)
- Trans-tracheal aspirates (obtained by physician via special procedure)
Specimen Required
Expectorated or suctioned (luki) sputum, bronchial washings, transtracheal aspirates in a clean, sterile, leakproof container.
Specimen Minimum Volume
1.0 mL of sputum
Specimen Stability Information
- Transport at room temperature.
- Specimen must be received within 2 hours of collection and refrigerated upon receipt.
- *NOTE* Specimens that do not meet the above criteria will be rejected.
Rejected Due To
- Not transported at room temperature.
- Specimen not received within 2 hours of collection and not refrigerated upon receipt.
- *NOTE* Specimens that do not meet the above criteria will be rejected.
Special Instructions
- Exam includes direct smear (gram stain) and susceptibility testing when appropriate for the isolates recovered.
- Sputum specimens are evaluated for quality based on gram stain findings.
- Specimens found to be consistent with saliva will not be accepted for culture.
- The collecting unit will be notified and a new collection will be requested.
Performing Laboratory
Glens Falls Hospital Microbiology Laboratory
Reference Values
Normal Respiratory Flore Present
Day(s) and Time(s) Performed
- Day Shift
- 7 days per week
Analytical Time
- 2-3 days normally
- Up to 4 days for pathogen isolation and susceptibilities
Specimen Retention Time
72 hours
Analytical Time
- 2-3 days normally
- Up to 4 days for pathogen isolation and susceptibilities