Acceptability of Sputum Specimens for Diagnosing Pulmonary Tuberculosis.
10.3346/jkms.2015.30.6.733
- Author:
Yeon Joo LEE
1
;
Sue SHIN
;
Eun Youn ROH
;
Jong Hyun YOON
;
Deog Kyeom KIM
;
Hee Soon CHUNG
;
Chang Hoon LEE
Author Information
1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Acceptable Sputum;
Tuberculosis, Pulmonary;
Sputum WBC
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Bacteriological Techniques/*methods;
Female;
Humans;
Male;
Middle Aged;
Mycobacterium tuberculosis/*isolation & purification;
Reproducibility of Results;
Sensitivity and Specificity;
Sputum/cytology/*microbiology;
Tuberculosis, Pulmonary/*diagnosis/*microbiology/pathology;
Young Adult
- From:Journal of Korean Medical Science
2015;30(6):733-736
- CountryRepublic of Korea
- Language:English
-
Abstract:
The evaluation of the quality of a sputum specimen prior to bacterial culture has been an accepted practice. However, optimal sputum criteria for pulmonary tuberculosis (TB) are not well established. We investigated indicators for sputum acceptability in tuberculosis cultures and acid-fast bacilli (AFB) smear. A post-hoc analysis of a randomized trial with 228 sputum specimens from 77 patients was conducted. In the trial, pulmonary TB suspects were requested for collecting three sputum specimens. We performed both TB study (AFB smear and M. tuberculosis culture) and Gram staining in each specimen. By using generalized estimating equations, the association between sputum characteristics and positive TB testings were analyzed. Although acceptable specimens for bacterial pneumonia showed higher TB-culture positive rates than unacceptable specimens (adjusted odds ratio [aOR]=1.66; 95% confidence interval [CI]=1.11-2.49), a specimen with > or =25 white blood cells/low-power field was the better predictor for positive M. tuberculosis cultures (aOR=2.30; 95% CI=1.48-3.58) and acid-fast bacilli smears (aOR=1.85; 95% CI=1.05-3.25). Sputum leukocytosis could be an indicator of sputum acceptability for diagnosing pulmonary tuberculosis.
