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At least 19 recordsLinked to original sources
PubMed1979

Precipitating antibodies against Haemophilus influenzae and Staphylococcus aureus in sputum and serum from patients with cystic fibrosis.

Serum and sputum sol phase from 23 patients with cystic fibrosis (CF) were examined for occurrence and titres of precipitins against Haemophilus influenzae and Staphylococcus aureus by means of crossed immunoelectrophoresis with intermediate gel. The patients had from four to nine H. influenzae precipitins in serum and in most cases fewer precipitins in sputum, but, on an average, there was no difference between the titres of the antibodies in serum and sputum. Most of the antibodies were cross-reactive with other species, notably those of the Haemophilus genus. S. aureus precipitins were generally found in higher numbers in serum than in sputum, but, on an average, the titre of the precipitins in sputum was higher than in serum. Three of the precipitins were detectable only in sputum and not in serum, and one of these is a S. aureus-specific precipitin. Most of the antibodies were cross-reactive with other species, and these antibodies were often present in sputum in much higher titres than in the corresponding sera. Antibodies against teichoic acid of the S. aureus cell wall could not be demonstrated in sputum, while they were present in 22 sera. The possible role of the local pulmonary humoral immune response in protective immunity and in the pathology of the lung disease in CF is discussed.

Adolescent↗
PubMed1977

Detection of penumococcal antigens in the sputum in pneumococcal pneumonia.

Forty-seven patients with bacterial pneumonia were grouped by use of clinical criteria according to the relative certainty of a diagnosis of pneumococcal pneumonia. Sputums were tested for pneumococcal antigens by counterimmunoelectrophoresis with polyvalent pneumococcal antiserum. Antigens were detected in the sputum of 29 of 39 patients with evidence of pneumococcal pneumonia, and there was good correlation between the detection of antigens and the degree of certainty of the clinical diagnosis. Antigens persisted briefly in the sputum during therapy with antimicrobial drugs and could be detected during the first 48 hours of therapy in most cases of pneumococcal pneumonia. Pneumococci were isolated from the sputum in only 18 of 39 cases of pneumococcal pneumonia, and sputum cultures did not correlate as well as counterimmunoelectrophoresis with clinical diagnoses. In studies of 27 patients with chronic bronchitis without pneumonia, pneumococci were isolated from sputum in 10 cases, whereas counterimmunoelectrophoresis was positive in 5 cases. Counterimmunoelectrophoresis provides a simple and rapid method for detecting pneumococcal antigens in sputum, and it appears to be more reliable than sputum cultures in establishing a presumptive diagnosis in pneumococcal pneumonia.

Adult↗
PubMed1979

Sputum counterimmunoelectrophoresis in the diagnosis of pneumococcal pneumonia.

Fifty-six patients with pneumonia were grouped according to degree of clinical certainty that the etiologic agent was Streptococcus pneumoniae. Of 14 patients with definite or probable pneumococcal pneumonia, 12 had pneumococcal antigens detected in sputum by counterimmunoelectrophoresis (CIE), 13 had a positive sputum culture, and 12 had a Gram-stained smear of sputum suggestive of the diagnosis. Of 9 patients with definite nonpneumococcal pneumonia, none had pneumococcal antigens detected by CIE, but one had pneumococci isolated from sputum culture, and one had a Gram stain of sputum suggestive of pneumococci. Of 34 control patients without pneumonia, five had a positive CIE, 11 had a positive culture, and 15 had a positive Gram stain. When used to differentiate pneumococcal from other types of pneumonia, CIE of sputum appears to be a sensitive and specific test. Among patients without pneumonia, however, CIE lacks specificity. Additionally, sputum Gram stain may correlate as well as CIE with pneumococcal pneumonia, but further substantiation of this observation is necessary.

Antigens, Bacterial↗
PubMed2025

Performance evaluation of a commercial multiplex pathogen panel for detection of bacteria in sputum specimens from non-ICU patients with suspected lower respiratory tract infection.

Rapid diagnostic testing can improve pathogen detection and lead to targeted antibiotics. The BioFire FilmArray Pneumonia Panel (BFPP) is a multiplex PCR that has displayed strong concordance with traditional microbiologic techniques. However, most existing literature focuses on deep respiratory specimens, and there is sparse literature on performance in sputum specimens. This retrospective, single-center study included adult patients between 1 September 2022 and 31 August 2024 who had collection of a BFPP with standard of care (SOC) culture from a sputum specimen on a non-intensive care unit (ICU) floor or in the emergency department if admitted to a non-ICU floor. Out of 189 BFPPs performed on 189 sputum specimens, a total of 141 bacterial targets were detected. Between the BFPP and SOC culture, the overall positive percent agreement and negative percent agreement (NPA) were 96.3% and 54.9%, respectively. The positive predictive value (PPV) was 26.3% while the negative predictive value was 98.9%. Patients with greater than 24 h of antibiotic exposure prior to BFPP collection had a lower PPV compared to patients with less than 24 h or no exposure (13.6% vs 29.6% vs 30.4%). The lowest concordance was observed for Haemophilus influenzae (15.4%), Moraxella catarrhalis (18.2%), Streptococcus pneumoniae (19%), and Staphylococcus aureus (22.7%), several of which are fastidious in culture. BFPP showed a high NPA, with all bacterial targets having an NPA greater than 90%, except H. influenzae (82%). Based on these data, a negative BFPP in sputum specimens could help to rule out a bacterial pneumonia, but the benefit of a positive test remains unclear.IMPORTANCEThis study evaluates the BioFire FilmArray Pneumonia Panel (BFPP) by comparing its performance to standard of care cultures exclusively in sputum specimens from non-intensive care unit patients with suspected lower respiratory tract infection. Findings show an overall high positive percent agreement and negative predictive value but a low negative percent agreement and positive predictive value, suggesting that a negative test in sputum specimens could be beneficial when attempting to rule out a bacterial infection, but the benefit of a positive test remains unclear, particularly if common airway colonizing bacteria are detected and at low semi-quantitative thresholds. Clinical symptoms should guide test interpretation in patients with positive BFPP results but negative culture growth.

Humans↗
PubMed1979

Serum and sputum antibiotic levels after ampicillin, amoxycillin and bacampicillin chronic bronchitis patients.

Serum and sputum concentrations of ampicillin or amoxycillin were measured in patients admitted to hospital for acute exacerbations of chronic bronchitis with purulent sputum. Mean peak serum levels of nearly 12 mg/l were found after 1600 mg bacampicillin (mean peak level in sputum 0.85 mg/l). The serum and sputum concentrations after 750 mg amoxycillin and 800 mg bacampicillin were comparable (mean peak serum levels approximately 9.5 mg/l, sputum concentrations 0.4 to 0.5 mg/l) although the drugs were not given in equimolar doses. Results after 1000 mg ampicillin by mouth were less satisfactory (mean peak serum level 7.8 mg/l) and only 0.25 mg/l was attained in the sputum. Minimum inhibitory concentrations of ampicillin and amoxycillin were measured for 177 Haemophilus influenzae strains. Most of the ampicillin MIC values were between 0.125 and 0.5 mg/l but more of the strains required 0.5 mg/l of amoxycillin. The amoxycillin MIC values were often one or two dilutions higher than those of ampicillin (p less than 0.001).

Amoxicillin↗
PubMed1979

Insignificance of colonic bacteria in the sputum of patients in a new ICU.

Over a 12-month period, 27% of patients in a new ICU grew bacterial pathogens from sputum or tracheal cultures. The commonest isolates were Pseudomonas aeruginosa and Klebsiella species. Endotracheal intubation, the length of time intubated, and antimicrobial therapy all predisposed to the isolation of organisms from sputum. No patient developed a gram-negative pneumonia, and there was no case of septicemia associated with a positive sputum culture. The presence of epithelial or pus cells in sputum was unrelated to the culture results. It was concluded that the growth of colonic bacteria from sputum or tracheal aspirates was of little prognostic or clinical significance. No significant common environmental site or cross-infection pathway was identified: sinks were contaminated by patients rather than vice versa. Most sputum isolates were probably endogenous in origin.

Adolescent↗
PubMed1978

Diagnosis of pneumococcal pneumonia by antigen detection in sputum.

Pneumococcal polysaccharide was detected by counterimmunoelectrophoresis in the sputum of 20 of 26 (77%) adults with community-acquired pneumonia and a positive sputum culture for Streptococcus pneumoniae. The test was negative in 29 pneumonia patients with negative sputum culture for S. pneumoniae. Pneumococcal antigen was also detected in the sputum of six of nine adults with chronic bronchitis and a positive sputum culture, but was not detected in expectorated respiratory secretions of 22 pneumococcal carriers with colds. Pneumococcal antigen could also be detected in sputum by immunodiffusion; antigen titers varied from 1:2 to 1:256. These results strongly suggest that the detection of pneumococcal antigen in respiratory tract secretions indicates infection caused by S. pneumoniae.

Adult↗
PubMed1977

Mediators of immediate-type hypersensitivity in sputum from patients with chronic bronchitis and asthma.

Mediators of immediate-type hypersensitivity were studied in the sputum of patients with chronic bronchitis. The same mediators were also measured in early-onset, skin-test-positive asthmatics, in late-onset, skin-test-negative asthmatics, and in patients with bronchial carcinoma, bronchiectasis, and pneumonia. Sputum eosinophilia was a feature of bronchitics and asthmatics, whereas raised blood eosinophil levels were found only in the early-onset, skin-test-positive asthmatics. Histamine and IgE were present in considerable amounts in the sputum of bronchitics and early-onset, skin-test-positive asthmatics. Smaller amounts were found in the other groups. The sputum in all the groups contained material giving an "S.R.S (slow-reacting substance) like" induced contraction of the guinea pig ileum. "Classical" S.R.S.-A., determined by arylsulphatase IIB susceptibility, was present only in bronchitics and both types of asthmatics. Since the bronchitics were, in general, skin-test negative and had normal concentrations of circulating IgE and eosinophils, it is suggested that the findings in the sputum indicate an element of local immediate-type (type I) hypersensitivity in bronchitis although its significance for pathogenesis is not known.

Adult↗
PubMed1979

Comparison of sputum counterimmunoelectrophoresis and culture in diagnosis of pneumococcal pneumonia.

The diagnostic value of counterimmunoelectrophoresis performed on sputum was compared with that of sputum culture. The detection of pneumococcal polysaccharide in sputum showed a better correlation with the presence of pneumococcal pneumonia than the recovery of pneumococci by culture. The authors conclude that sputum counterimmunoelectrophoresis can provide diagnostic guidance to physicians awaiting the results of sputum culture and aid in the interpretation of cultural findings.

Bacteriological Techniques↗
PubMed1977

Misinformation from sputum cultures without microscopic examination.

Only 13 of 38 hospital laboratories surveyed include a Gram stain routinely in microbiological sputum examination. In a prospective three-hospital study, 60% of over 1,200 "sputum" specimens consisted predominantly of saliva, as judged by cell composition. Compared with the results of cultures in which microorganisms presumptively identified on sputum smears were specifically sought ("directed cultures"), cultures of the same specimens processed in the routine manner missed pneumococci 61%, haemophili 23%, and yeasts 44% of the time. The findings were similar in all three hospitals despite differences in administration, staffing, primary culture media, and workload. Unless microscopic examination is routinely included, half of all microbiological information rendered on sputum specimens is meaningless and subject to dangerous misapplication. Furthermore, culture must be guided by microscopic findings, or respiratory pathogens will frequently be missed. Finally, when routine culture and smear disagree, the culture cannot be assumed to be correct. Microscopic examination should be mandatory in sputum microbiology, both for specimen evaluation and as a guide to what to look for in culture.

Bacteriological Techniques↗
PubMed1977

[Quantitative bacteriology of sputum and bronchial secretions in patients with chronic bronchitis (author's transl)].

The in vitro and in vivo reproducibility of the quantitative bacteriological analysis of sputum and bronchial secretions has been studied in patients with chronic bronchitis. Sputum produced during bronchial toilet showed a significant higher bacterial numeration than that produced by physiotherapy but the bacterial species identified were identical. No significant variations were observed between the qualitative and quantitative bacteriologic flora of bronchial secretions collected by bronchoscopy from different segments of the airways. Comparison of microbial counts on sputum specimens collected at different periods of the day and at weekly intervals over several weeks revealed that the sputum of clinically stable chronic bronchitic patients contain a relatively constant and potentially pathogenic bacterial flora. The emergence of a superinfection was emphasized by the parallel increase of the leukocytic and bacterial numeration of sputum.

Bacteria↗
PubMed1979

Demonstration of tuberculostearic acid in sputum from patients with pulmonary tuberculosis by selected ion monitoring.

Selected ion monitoring was used to detect tuberculostearic acid (10-methyloctadecanoic acid) in sputum from patients with pulmonary tuberculosis. The specimens were autoclaved, lyophilized, extracted, and methanolysed before being subjected to thin-layer chromatography and injected into the gas chromatograph/mass spectrometer. Tuberculostearic acid could be detected in five of six tuberculous sputum specimens containing acid-fast rods detectable by light microscopy of Ziehl-Neelsen stained smears. After the sputum specimens had been cultured for five days on Löwenstein-Jensen medium, when still no colonies could be observed visually, the presence of tuberculostearic acid was demonstrated in all six cases of tuberculosis. In corresponding analyses of sputum from eight patients with non-tuberculous pneumonia, tuberculostearic acid was not found. This fatty acid, the presence of which was also demonstrated in cultures of various mycobacterial and nocardial species, is characteristic of organisms of the order Actinomycetales. The demonstration of tuberculostearic acid in sputum specimens may constitute a rapid and sensitive way of diagnosing pulmonary tuberculosis.

Chromatography, Gas↗
PubMed1978

Fungal spores in lung and sputum.

A survey of fungal aerospora over a 2-year period was combined with an investigation of the fungi cultured from 295 samples of peripheral human lung and 2466 samples of sputum over the same period. 83% of lung and 88% of sputum samples contained culturable fungi, although in 16% of lung and 31% of sputum samples Candida albicans was the only one. Those fungi of small spore size tended to be found in lung tissue while those with larger spores were more likely to be found in the sputum. While their presence in the respiratory tract was related to their occurrence in the air, differences in their frequencies in the air and lung suggested that the lung had a selective inhibitory effect on the development of different spores. In particular, Aspergillus fumigatus was cultured more frequently than would have been anticipated from its profusion in the air.

Aged↗
PubMed1978

Survival of Streptococcus pneumoniae in sputum from patients with pneumonia.

The isolation rate of Streptococcus pneumoniae in sputum cultures from patients with pneumococcal pneumonia is low. An investigation was made to determine whether this low yield might be due to loss of pneumocci and/or overgrowth by pharyngeal flora before the specimen is plated. Pneumococcal survival times and pharyngeal overgrowth at 4 degrees C and at room temperature were determined in sputum obtained from 42 patients with pneumococcal pneumonia. It was found that pneumococci survived for long periods in sputum--2.2 +/- 1.4 days at room temperature and 9.5 +/- 3.6 days at 4 degrees C. Overgrowth by pharyngeal flora occurred in only 6 of 42 specimens kept at 4 degrees C and 31 of 42 specimens kept at room temperature. The low yield of S. pneumoniae in sputum from patients with pneumococcal pneumonia is not explained by decreased viability of the organism.

Adult↗
PubMed1979

Sputum screening by Nomarski interference contrast microscopy.

Gram-stained smears of specimens submitted for sputum cultures were compared with direct wet mounts examined by Nomarski interference contrast microscopy (NIM) for enumeration of squamous epithelial cells (EPC) and leukocytes (WBC). The results obtained by the two methods were comparable, but specimens were more rapidly screened and cell types were more readily differentiated by NIM. Specimens submitted for sputum culture over a 3-month period were examined for EPC and WBC by NIM. Twenty-two percent of the specimens had greater than 25 EPC/field or a predominance of EPC (class I), 30% had greater than 25 EPC and greater than 25 WBC/field (class II), and 48% had greater than 25 WBC/field or a predominance of WBC (class III). The clinical relevance of the culture results was determined by reviewing the records of patients whose specimens were included in the study. Class I specimens provided only 30% clinically relevant culture results. Specimens in class II provided useful culture results in 63% of the patients, and 96% of those in class III provided clinically relevant information. The results confirm the value of sputum screening and demonstrate that NIM provides a rapid, simple, and accurate method for sputum screening.

Diagnosis, Differential↗
PubMed1978

Isolation of Staphylococcus aureus from sputum in cystic fibrosis.

The success in the isolation of Staphylococcus aureus of different methods of sputum processing was investigated in 60 specimens collected from 14 patients with cystic fibrosis during a seven-month period. Fifty specimens (83%) from 11 patients yielded Staph. aureus by one or more methods. Direct plating of purulent portions of sputum on to media designed for general use in respiratory infections gave unsatisfactory results (35% yield of Staph. aureus). Some increase in isolations was obtained with preliminary liquefaction of sputum; but the best results were given by the addition of a medium selective for staphylococci (mannitol salt agar, BBL) or by initial sonication of sputum (each 83% yield). Seven of the 11 strains of Staph. aureus were thymidine-dependent and otherwise atypical in laboratory characteristics; these were isolated from patients who had received co-trimoxazole.

Adolescent↗
PubMed1978

Pus, deoxyribonucleic acid, and sputum viscosity.

On 100 sputum specimens selected from patients suffering from chronic bronchitis, bronchiectasis, asthma, and cystic fibrosis total deoxyribonucleic acid (DNA) content has been related to macroscopic type, to total dry weight yield, and to the apparent viscosity of the secretion at 1350 s-1: since DNA may be present, either as fibres or within cells, in one-third of the specimens the contribution of each form to the apparent viscosity was assessed. The effect on sputum viscosity of the addition of DNA in vitro has also been studied. Whereas between mucoid, mucopurulent, and purulent macroscopic types a significant difference in total DNA and dry weight yield has been found, viscosity was not significantly correlated with purulence. Similarly, the concentration of either cells or fibres correlated significantly with total DNA but not with viscosity. The in vitro addition of DNA to sputum caused a significant increase in its viscosity, and reasons for the differences between the iv vivo and in vitro effect are discussed. Certain constituents of purulent sputum tend to increase viscosity and others to reduce it, and the influence of these varies in the several diseases studied.

Adolescent↗
PubMed1979

Counterimmunoelectrophoresis of sputum and blood for the diagnosis of chest infections caused by pneumococci or Haemophilus influenzae.

In 107 patients with lower respiratory tract infections, counterimmunoelectrophoresis (CIE) of blood and sputum, bacterial cultures of blood, sputum and nasopharyngeal secretion, and enzyme-linked immunosorbent assay (ELISA) for antibody determination were performed, with special reference to pneumococci and Haemophilus influenzae. For pneumococci CIE of sputum was superior to culture especially in antibiotic-treated patients. The clinical significance of a positive CIE of sputum was supported by close correlation to significant antibody increase. The usefulness of CIE regarding H. influenzae was more difficult to evaluate.

Adult↗