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PubMed1988

Efficacy of specimen radiography of clinically occult noncalcified breast lesions.

Breast biopsy specimen radiography is required to ensure the accurate removal of clinically occult lesions discovered by mammography. Although used routinely for calcified lesions, it has not been widely accepted for those abnormalities that do not contain calcium. To determine the efficacy of film-screen specimen radiography for confirming the presence of clinically occult, noncalcified lesions, we undertook a prospective study of 104 specimen radiographs obtained after mammographically guided hookwire localization and planned excision of these lesions. Ninety-seven (93%) of the excised abnormalities were visualized on specimen mammograms. Malignancy was found in 22 (21%) of them. Thirty-five percent of the specimen radiographs showed better anatomic detail of the lesion, 48% showed the same detail, and 16% showed less detail than the original mammograms. Specimen radiographs failed to show the lesion in only seven cases. Five of the seven were true-negative specimen radiographs, making the efficacy rate 98%. Film-screen specimen radiography of clinically occult, noncalcified lesions is a highly effective procedure for correctly identifying the presence of a mammographic abnormality.

Breast Diseases↗
PubMed2002

Spontaneous in vitro contractile activity of specimens from the abomasal wall of healthy cows and comparison among dairy breeds.

OBJECTIVE: To characterize and compare in vitro contractility patterns of sections of abomasal wall harvested from cattle of 3 dairy breeds. SAMPLE POPULATION: Longitudinal and circular smooth muscle preparations harvested from the antrum and body of the abomasum of 30 recently slaughtered Holstein-Friesian, Brown Swiss, and Simmental X Red Holstein cows. PROCEDURE: Spontaneous isometric contractions of specimens in tissue baths of modified Krebs solution were recorded during a 4-hour period. Maximal amplitude, frequency of contractions, and change of basal tension were used to characterize contractility. Statistical analyses were used to test for differences among time periods, among breeds, between specimen locations, and between fiber orientations. RESULTS: Myoactivity patterns of abomasal smooth muscle preparations are highly variable and differ on the basis of location and fiber orientation. Frequency of contractions differed significantly among time periods for longitudinally oriented specimens with decreasing frequencies of contractions over time. Maximal amplitude of the longitudinally oriented specimens from the antrum increased significantly, whereas maximal amplitude of the circularly oriented specimens from the antrum decreased significantly. Values did not differ significantly among breeds. CONCLUSIONS AND CLINICAL RELEVANCE: Patterns of spontaneous contractility of abomasal wall specimens are not homogeneous. During a 4-hour recording period, maximal amplitude and frequency of contractions of specimens varied significantly with respect to orientation and location; however, spontaneous contractile myoactivity did not differ significantly among breeds. Therefore, breed predisposition for displaced abomasum is not correlated with spontaneous activity of smooth muscle specimens.

Abomasum↗
PubMed2006

Detection of feline herpesvirus 1 DNA in skin biopsy specimens from cats with or without dermatitis.

OBJECTIVE: To compare detection rates of feline herpesvirus 1 (FHV-1) DNA in skin biopsy specimens from cats with herpetic dermatitis, cats with nonherpetic dermatitis, and cats without dermatitis. DESIGN: Prevalence survey. Animals-5 cats (9 biopsy specimens) with herpetic ulcerative dermatitis, 14 cats (17 biopsy specimens) with nonherpetic ulcerative dermatitis, and 8 cats (21 biopsy specimens) without clinically apparent skin lesions. PROCEDURES: A single-phase PCR assay was used to detect FHV-1 DNA in biopsy specimens. Assay results were compared with results of histologic examination. RESULTS: FHV-1 DNA was detected in all 9 biopsy specimens from the 5 cats with herpetic dermatitis and in 1 of 17 biopsy specimens from the 14 cats with nonherpetic dermatitis, but was not detected in any of the 21 biopsy specimens from the 8 cats without dermatitis. When results of histologic examination were used as the gold standard, sensitivity and specificity of the PCR assay were 100% and 95%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Results confirmed that FHV-1 DNA can be detected in the skin of cats with herpetic dermatitis and suggest that the virus may play a causative role in the disease. In addition, the PCR assay may be useful in confirming a diagnosis of herpetic dermatitis.

Animals↗
PubMedDate not supplied

[Evaluation of the MTD-2 test for the direct detection of Mycobacterium tuberculosis in specimens].

BACKGROUND: To evaluate the utility of the Amplified Mycobacterium Tuberculosis Direct Test (MTD-2, Gen-Probe) in the microbiological diagnosis of tuberculosis. METHODS: We evaluated the results obtained in 146 specimens with the MTD-2 test, together with those of the culture and smears. The MTD-2 test was performed on all the smear positives specimens (n=47), on the smear-negative specimens, when the test was demanded (n=19), and in other smear-negative specimens previously selected, according to the clinical history of the patient (n=80). We considered real cases of tuberculosis, those that were culture positive for Mycobacterium tuberculosis and those that were specifically treated. RESULTS: The overall sensitivity, specificity, positive and negative predictive values for the MTD test were: 95, 76, 71, and 96%, for the culture; and 84, 100, 100 and 90% and 75, 94, 89 and 86% for the smears, respectively. In smear positive specimens, the test showed a great specificity, and differentiated M. tuberculosis from other mycobacteria. In the smear negatives, the sensitivity of the test was low and so was the positive predictive value, especially in series performed with a high work load. CONCLUSIONS: Data from our study show that the MTD-2 test is a reliable method for rapid diagnosis of tuberculosis in smear positive specimens. However, due to its low sensitivity and positive predictive value, it is not recommended in the routine diagnosis of tuberculosis. Also, for this reason, whenever a positive result is obtained with a smear negative specimen, the result needs to be confirmed with another specimen.

Bacteriological Techniques↗
PubMed1999

Evaluation of the enhanced amplified Mycobacterium tuberculosis direct test for direct detection of Mycobacterium tuberculosis complex in respiratory specimens.

OBJECTIVE: To evaluate the performance of the enhanced Mycobacterium Tuberculosis Direct Test (E-MTD), for the direct detection of M tuberculosis complex (MTBC) in respiratory specimens. DESIGN: Two hundred seventy-four respiratory specimens from 151 patients in respiratory isolation were tested with the E-MTD, and the results were compared with the results of mycobacterial smear, culture, and the earlier form of the test, MTD-1. RESULTS: Forty-one specimens were culture positive for mycobacteria (20 MTBC and 21 nontuberculous mycobacteria), 23 of which were smear positive (16 MTBC, 7 nontuberculous mycobacteria). Twenty-four specimens were positive by E-MTD, and 21 were positive by MTD-1. Of the 20 MTBC culture-positive specimens, 19 were positive by the E-MTD and 19 were positive by the MTD-1. The remaining specimens were MTBC negative by all methods. After resolution of discrepancies, the sensitivity, specificity, and positive and negative predictive values were 95.2%, 100%, 100%, 99.6% for the MTD-1 and 95.2%, 98.8%, 87.0%, and 99.6%, for the E-MTD. For the E-MTD smear-positive and smear-negative specimens, these same values were 93.8%, 100%, 100%, and 87.5% and 100%, 98.8%, 62.5%, and 100%, respectively. CONCLUSION: The results suggest that the E-MTD is a reliable method for the direct detection of MTBC in smear-positive respiratory specimens.

Bacteriological Techniques↗
PubMed2001

Evaluation of HBV and HCV antigens expression in correlation with HBV DNA and HCV RNA occurrence in liver biopsy specimens of patients with chronic hepatitis type B and chronic hepatitis type C, respectively.

MATERIAL AND METHODS: The material studied consisted of single liver biopsy specimens and serum samples from 97 patients diagnosed by clinical and serological criteria as having chronic hepatitis of either type B (38 patients seropositive for HBsAg) or type C (59 patients seropositive for anti-HCV). Diagnosis of chronic hepatitis, including grading and staging of the process, was established by histopathological examination of routinely stained serial paraffin sections. The expression of HBV and HCV antigens was detected in frozen sections by amplified immunoperoxidase method (EnVision, DAKO) with the use of monoclonal anti-HBs antibodies (DAKO), polyclonal anti-HBc antibodies (Biogenex) and FITC-labeled human antibodies to HCV antigens. HBV DNA and HCV RNA were searched for in tissue homogenates with PCR (In Gen; Terpol, Sieradz) and RT PCR (Cobas Amplicor HCV RNA, Roche), respectively. RESULTS: HBsAg was detected in all and HBcAg in 26 of the 38 biopsy specimens with chronic hepatitis type B from patients who were seropositive for HBsAg and anti-HBc, and for either HBeAg (25 cases) or anti-HBe (13 cases). HBV DNA was identified in 32 out of 38 liver biopsy specimens. Out of the 32 HBV DNA positive specimens, 6 that had been obtained from patients seropositive for anti-HBe, lacked HBcAg expression. HCV antigens were found in 27 (50%) out of 54 specimens which showed the presence of HCV RNA. CONCLUSIONS: These results are indicative for a strong positive correlation between the expression of HBV antigens and that of HBV DNA in liver biopsy specimens. The detection of HCV antigens has proved to positively correlate with that of HCV RNA in 50% of the specimens examined. It appears, therefore, that testing of liver biopsy specimens for HBV and HCV antigens may, in a significant proportion of cases, extend the histopathological diagnosis as to include identification of the etiologic factor.

Antigens, Viral↗
PubMed2002

Use of nested polymerase chain reaction for the detection of cytomegalovirus in clinical specimens.

BACKGROUND & OBJECTIVES: Since fluorescent antibody test (FAT) has low sensitivity in the rapid detection of cytomegalovirus (CMV) in clinical specimens, a nested polymerase chain reaction (nPCR) to detect the CMV-DNA was evaluated. METHODS: nPCR and FAT were carried out to detect CMV in single specimens from 104 patients and dual specimens from 32 patients with suspected active CMV infection. Of the 136 patients, 3 were HIV positive. RESULTS: CMV was detected by FAT alone in 3 (1.8%) and FAT and nPCR in 16 (9.5%) specimens and by nPCR alone in 84 (50.0%) specimens from 74 (54.4%) patients. nPCR increased the clinical sensitivity by 50.0 per cent in the specimens and 54.4 per cent in the patients (McNemar test, P < 0.001). Urine was found to be the ideal specimen for the detection of CMV as the detection rate in the urine was statistically higher (McNemar test, P < 0.05) than in the blood. Buffy coat and plasma samples from 35 normal blood donors were subjected to nPCR and ELISA respectively. CMV-DNA was not detected in any of the samples while anti-CMV antibodies were detected in all of them. INTERPRETATION & CONCLUSION: The results showed that presence of CMV-DNA in the specimen indicates active infection and nPCR is a rapid, sensitive, specific and a more reliable diagnostic tool than FAT.

Adult↗
PubMed1992

Detection of metastatic neuroblastoma in bone marrow biopsy specimens with an antibody to neuron-specific enolase.

To verify the practical utility of immunohistochemical analysis of bone marrow biopsy specimens in patients with neuroblastoma, we compared the results of routine histologic examination of 68 specimens with the results of immunohistochemical detection of tumor cells using an antibody to neuron-specific enolase (NSE). A commercially available polyclonal antibody to this enolase isoform consistently reacted with the neoplastic cells in biopsy specimens with histologic features diagnostic of (24 specimens) or suspicious for (one specimen) metastatic neuroblastoma. Immunohistochemical double-staining techniques documented that the NSE-positive neoplastic cells also reacted with antibodies to chromogranin and synaptophysin. Notably, anti-NSE detected small foci of metastatic neuroblastoma in two of 43 biopsy specimens that showed no evidence of metastatic tumor in the initial histologic sections. Rare NSE-reactive hematopoietic cells were present in approximately a third of the specimens with and those without neuroblastoma and were easily distinguished from metastatic tumor by morphologic examination. We conclude that this antibody to NSE consistently detects neuroblastoma cells in routinely processed bone marrow specimens, including small foci of tumor cells not evident in initial histologic sections.

Antibodies↗
PubMed1992

Creatinine analysis in single collection urine specimens.

Controlled and uncontrolled fluid intake studies were conducted on series of volunteers over the 6 or 12 h of the study periods. Urine specimens were obtained from each subject randomly or at specified times relative to fluid ingestion. Creatinine analysis performed by a modification of the Abbott TDx procedure demonstrates that the values obtained from single collection specimens fall almost in the same range as the values from 24 h pooled collection specimens. The creatinine concentration can be used to indicate possible adulteration of urine specimens by dilution as a means of avoiding detection of use of drugs of abuse. Between 4 and 7 h are required for a decrease in creatinine concentration to about 100 mg/dL from an initial mean of about 170 mg/dL. A minimum of 6 h is needed for any creatinine value to fall to 50 mg/dL or less. Thus, it appears that creatinine output is sensitive to the amount of fluid ingested, but the relationship is neither linear nor immediate. The absence of a significant creatinine concentration in a specimen can be used as an indication of direct or indirect adulteration of the urine specimen by dilution or replacement with water. At NDSL-Great Lakes, a decline of the creatinine concentration to 30 mg/dL is used as a cutoff for differentiating between urine specimens that might have been tampered with to avoid detection of drug use and those specimens that are dilute for other reasons. Values at 10 mg/dL or less are suggestive of replacement by water. The information is provided to local commands for investigation prior to initiation of punitive action by the command.

Creatinine↗
PubMed2005

[Isolation of Serratia marcescens from patient specimens in one Japanese hospital between April 2002 and March 2004].

In this study, the isolation frequency, 131 isolates including seven duplicates from the same patient, of Serratia marcescens from patient specimens obtained at Showa University Fujigaoka Hospital between April 2002 and March 2004 was investigated in comparison with 156 isolates including 8 duplicates, obtained between April 1999 and March 2002. The isolation percentage of 40%, 53 isolates from respiratory specimens in the recent period was the same with that of 40%, 62 isolates in the previous period, while that percentage of 12%, 16 isolates from urine specimens, was significantly smaller than the previous percentage of 24%, 37 isolates p < 0.01, X2-test). Furthermore, the isolation percentage of 41%, 20 of 49 isolates with serotype 02 from respiratory specimens, in the recent period did not significantly differ from that of 43%, 18 of 42 isolates, in the previous period. However, the isolation percentage of 24%, 9 of 37 isolates with serotype 014 from urine specimens, in the recent period was significantly smaller than that of 67%, 20 of 30 isolates, in previous period (p < 0.001, chi squared-test). The decrease in this period resulted from having avoided unnecessary monitoring for urinary tract infection without diagnostic value. The isolation percentage of 12%, 16 isolates from blood specimens, in this period was significantly greater than that of 3%, 4 isolates, in the previous period (p < 0.001, chi squared-test). By pulsed-field gel electrophoresis (PFGE) analysis of Spe I-restricted chromosomal DNA, clones from 5 of 6 isolates from blood specimens were identical to the isolate from another specimen (sputum, catheter-derived urine, indwelling catheter, used IVH catheter tip, or used drainage tube), while the one remaining isolate were a neighbor clone to the isolate from aspirated sputum. Such incidents seemed to have been caused by serratial cross-contamination in the hospital, reflecting inadequate practice of standard precautions.

Electrophoresis, Gel, Pulsed-Field↗
PubMed1991

Impact of endocervical specimen quality on apparent prevalence of Chlamydia trachomatis infections diagnosed using an enzyme-linked immunosorbent assay method.

Duplicate endocervical swabs were collected from 1824 patients for detection of Chlamydia trachomatis. Specimen pairs were combined into 400 microL of 0.9% saline solution. After vortexing, a 40-microL sample was smeared and stained with Papanicolaou's method for detection of endocervical and/or metaplastic (E-M) cells. The remaining specimen was tested for C trachomatis antigen with the use of an enzyme-linked immunosorbent assay (ELISA) procedure (Chlamydiazyme, Abbott Laboratories, North Chicago, Ill). Chlamydia trachomatis antigen was detected and confirmed (with the use of a blocking antibody [Abbott Laboratories]) in only 16 (1.7%) of 918 specimens that lacked detectable E-M cells, but it was detected significantly more frequently not only in 88 (13.3%) of 661 specimens that contained detectable E-M cells but also in 32 (13.1%) of 245 specimens that contained too many red blood cells to analyze microscopically. Of the initially positive ELISA results, none of 37 were falsely positive from specimens that contained 11 or more E-M cells, but significantly more (six [27.3%] of 22) were falsely positive from specimens that lacked detectable E-M cells. Variations in specimen quality had a significant impact on the incidence of both true-positive and false-positive ELISA results and could significantly influence understanding of the prevalence of chlamydial infections in women.

Adolescent↗
PubMed1987

Standard specimens for stain calibration and their application to the Papanicolaou stain.

Standardized specimens composed of extracts of biologic objects (nucleoprotamine and bovine liver) were developed as tools for the quantitative evaluation of stain performance on biologic substrates. The specimens are mixtures of proteins and nucleic acids and thus mimic the staining characteristics of cytologic smears. The concentration of each mixture and the specimen thickness can be precisely controlled, ensuring the production of a large number of samples with a nearly identical capability for dye binding. The transmitted light spectra of the standardized specimens varied depending on the extract and the preparation conditions. Spectra similar to those reported from the nuclei and cytoplasm of cell types in Papanicolaou-stained cervicovaginal smears were observed. Light transmission was uniform to +/- 5% across each specimen and from specimen to specimen. The specimen thickness was uniform within +/- 2%. Studies with these standardized samples could reveal the much-needed correlations between the chemical and optical characteristics of dyes and dye solutions and the performance of the dyes on biologic substrates.

Animals↗
PubMedDate not supplied

Lymphocyte growth from cardiac allograft biopsy specimens with no or minimal cellular infiltrates: association with subsequent rejection episode.

Histologic features of endomyocardial biopsy specimens are essential in the monitoring of heart transplant patients. Significant cellular infiltrates accompanied by myocyte damage are diagnostic of transplant rejection, whereas no or minimal infiltrates (grades 0 and 1) suggest absence of rejection. Biopsy specimens were cultured on the basis of the principle that the allograft is infiltrated by activated lymphocytes, which can be expanded in the presence of interleukin-2, a lymphokine that induces proliferation of activated T cells. Although frequency of cell cultures was proportional to histologic rejection grade, 39% of biopsy specimens with grades 0 and 1 cultured during the first month posttransplantation yielded lymphocyte growth. Cell growth was observed in 28% of biopsy specimens with grades 0 and 1 obtained during the first 10 days posttransplantation. In this group (growers) 73% showed clinical rejection after 9.8 +/- 5.0 days. In contrast, 55% of nongrowers were treated for rejection after 19.1 +/- 13.8 days. For biopsy specimens obtained 11 to 20 days posttransplantation, subsequent rejection episodes were observed in 61% of growers, but in only 33% of nongrowers. For biopsy specimens obtained 21 to 30 days posttransplantation the incidence of clinical rejection was 60% versus 14%, respectively. A sequential analysis of biopsy specimens obtained during the first month posttransplantation enabled us to identify 16 persistent nongrowers; only 6 (37%) experienced clinical rejection during the first 3 months posttransplantation. Most of the persistent nongrowers were found among patients on the immunoprophylactic rabbit antithymocyte globulin protocol. These data suggest that in vitro cultures of biopsy specimens with no detectable or minimal cellular infiltration may be useful in identifying patients at risk of developing rejection.

Adult↗
PubMed1985

Effect of operative devascularization on estrogen and progesterone receptor levels in breast cancer specimens.

To compare estrogen and progesterone receptor values between biopsy and mastectomy specimens, we prospectively studied 29 patients with breast cancer treated by incisional biopsy followed by mastectomy. The average tumor size was 5.4 +/- 0.5 cm and the mean age was 57.6 +/- 3.0 years. Nine patients were premenopausal and 20 were postmenopausal. Biopsies were performed without electrocautery, and tissue samples were promptly frozen and subsequently assayed for estrogen and progesterone receptor levels. After mastectomy, samples of residual tumor were excised from the biopsy site, promptly frozen, and assayed for estrogen and progesterone receptor levels. Operating time averaged 87.7 +/- 6.0 minutes. Estrogen receptor levels averaged 100.0 +/- 24.4 femtomole per mg on biopsy specimens and 29.5 +/- 8.2 fmol/mg on mastectomy specimens, representing a 70% decline (p less than 0.02). Of clinical significance is the fact that eight of 29 (27.6%) tumors changed from positive estrogen receptor values in the biopsy specimen to negative (four) and borderline (four) in the mastectomy specimens. Progesterone receptor levels were more variable, but their mean value decreased by 24.4% from 17.6 +/- 6.4 fmol/mg on biopsy samples to 13.3 +/- 4.3 fmol/mg on mastectomy samples (p, not significant). We conclude that the biopsy specimen is usually a more reliable indicator of hormonal receptor status than the mastectomy specimen and recommend that incisional or excisional biopsy specimens be taken for estrogen and progesterone receptor assays before mastectomy.

Adult↗
PubMed1984

Simulation model for gynecologic specimen classification in a high-resolution prescreening system.

Presentation is made of the design of a statistical model for the generation of "artificial specimens" to be used in the development and testing of a high-resolution prescreening system for gynecologic specimen classification. The model is based on two considerations: (1) the nature of the biologic material to be examined and (2) the system to be studied, which in this case is the FAZYTAN cervical prescreening system. Since gynecologic specimens that belong to the same clinical class (Papanicolaou group) have similar compositions of the different cytologic cell types, the simulation model presented is based on the close relationship between the degree of cancer suspiciousness expressed in the clinical diagnostic group and the composition of the cellular samples on a specimen. Statistically, the model considered here is based on an analysis of the single-cell classification (SCC) output process, taking the inherent system properties into account. The statistical information obtained by evaluating large sets of labelled cells is then used to produce artificially generated point distributions in the SCC decision space ("artificial specimens"), which can be used for examination of system reactions under controlled conditions. False-positive and false-negative error rates and system operation characteristics can be measured, and the effects of varying cell compositions as well as the relative performance of different specimen classifiers can be investigated. Although the "artificial specimens" thus created allow the investigation of system reactions with respect to a great variety of input processes, they cannot replace experiments on thousands of original specimens in order to measure system quality under realistic conditions.

Cytological Techniques↗
PubMed1982

The cloverleaf skull anomaly: an anatomic and histologic study of two specimens.

Two neonatal human specimens exhibiting the cloverleaf skull anomaly were studied in detail using gross, radiographic and histologic techniques. Both specimens exhibited premature fusion of the right and left coronal sutures, right and left lambdoidal sutures, and midsagittal sutures. Although the specimens grossly exhibited a similar trilobed appearance of the craniofacial complex, the interrelationship and spatial orientation of their respective articular and skeletal components differed markedly. The development of the cranial base in one specimen appeared normal, while in the other specimen, the synchondroses between the supraoccipital, exoccipital, basioccipital, basisphenoid, and presphenoid bones were prematurely obliterated histologically, resulting in a substantial decrease in the length of the cranial floor. The latter specimen also exhibited micromelic shortening of the limbs with abnormal chondrocyte proliferation and maturation at the epiphyseal growth plates. The alterations in the size and shape of the calvarial bones subsequent to premature sutural synostosis were more severe in the specimen with premature closure of the cranial base synchondroses. The striking differences observed in the anatomic and histologic analysis of the specimens demonstrated tha the cloverleaf skull malformation must be etiologically and pathogenetically heterogeneous.

Abnormalities, Multiple↗
PubMed1994

Prevalence of antibody to the human immunodeficiency virus among clinical laboratory specimens: findings from a survey of primary care physicians.

To evaluate human immunodeficiency virus type 1 (HIV-1) infection among patients of primary care physicians, we performed anonymous, unlinked HIV-1 antibody testing on leftover blood specimens submitted to 10 large commercial clinical laboratories for complete blood cell count or hematocrit determination, the most commonly ordered diagnostic tests. From January through August 1990, 55,613 specimens submitted by general internists, pediatricians, and family practitioners were sampled; 1,104 (2.0%) had HIV-1 antibody. Seroprevalence among the laboratories varied 50-fold, from 0.3 to 12.4%. The HIV-1 prevalence at each laboratory was not always consistent with the AIDS incidence in the area served by the laboratory. Overall the seroprevalence was almost eight times higher in men (3.9%) than in women (0.5%). Specimens from seropositive persons, especially from men, were unevenly distributed among the physician practices; only three practices submitted approximately 50% of all specimens from seropositive men. These data indicate that a few physicians treat the majority of HIV-1-infected primary care patients. The HIV-1 prevalence among specimens at a clinical laboratory is thus determined by whether few physicians submit specimens to that laboratory. These results could be of use, for instance, in analyzing proposals to mandate physician reporting of HIV-1 infection. The high HIV-1 prevalence among laboratory specimens underscores the potential for exposure to HIV-1-infected blood by clinical laboratory personnel and emphasizes the need for universal precautions for all blood specimens.

Adolescent↗
PubMed1977

Experience with a microscopic screening program for sputum specimens.

Microscopic examination of almost 2,000 sputum specimens was performed over a 3 1/2-month period. The specimens were categorized into 6 groups based on numbers of leukocytes (PMN's) and squamous epithelial cells (SEC's) observed at low magnification (X 100). Bacteriologic evaluation of specimens consisted of identification and antimicrobial susceptibility tests of potential pathogens when growth was equal or predominant to the growth of oropharyngeal flora. Specimens containing greater than 25 PMN's and less than 25 SEC's had potential pathogens identified in 51% of the samples. Specimen containing greater than 25 SEC's and any number of PMN's showed a rate on only 19%. Specimens containing less than 25 PMN's and SEC's had a rate of 13%. Since initiating the screening program in which sputum specimens containing greater than 25 SEC's were unacceptable for culture, the per cent of acceptable specimens received by the laboratory nearly doubled.

Bacteria↗