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Sputum is a thick fluid produced in the lungs and in the adjacent airways. Normally, fresh morning sample is preferred for the bacteriological examination of sputum. [2] A sample of sputum is collected in a sterile, wide-mouthed, dry, leak-proof and break-resistant plastic-container and sent to the laboratory for testing. [2]
The best sputum samples contain very little saliva, [2] as saliva contaminates the sample with oral bacteria. This is especially true for samples for laboratory testing in cytology or microbiology. Specimen adequacy is assessed by the laboratory technologists by examining a Gram stain or cytology stain of the sputum.
In a clinical study conducted the sensitivity of the MTB/RIF test on just 1 sputum sample was 92.2% for culture-positive TB; 98.2% for smear+ and culture-positive cases; and 72.5% for smear-negative, culture-positive cases, with a specificity of 99.2%. Sensitivity and higher specificity were slightly higher when 3 samples were tested. [10]
The medical history includes obtaining the symptoms of pulmonary TB: productive, prolonged cough of three or more weeks, chest pain, and hemoptysis.Systemic symptoms include low grade remittent fever, chills, night sweats, appetite loss, weight loss, easy fatiguability, and production of sputum that starts out mucoid but changes to purulent. [1]
A sputum sample will also be obtained to ascertain the causative bacteria. This also plays a role in informing treatment options. [5] [6] In some cases, pulse oximetry may also be required as pneumonia is known to deplete oxygen levels in the blood. [7] Other vitals such as pulse and body temperature are also checked.
Sampling of sputum from the lungs for sputum culture. It can be performed by special techniques of coughing, or by a protected specimen brush (PSB), [ 1 ] which is a brush that can be retracted into a plastic tube to prevent contamination of bacteria in the throat while inserting and removing the instrument.
Once in the stomach, the acids and digestive system will remove the phlegm and get rid of the germs in it. [1] In some cultures, swallowing phlegm is considered a social taboo, being described as disgusting or unhygienic. [15] One Igbo adage, for example, uses the swallowing of phlegm as a metaphor for wrongdoing. [16]
For example, different types of samples must be collected in appropriate tubes to maintain the integrity of the sample and stored at appropriate temperatures (usually 4 °C) to preserve the virus and prevent bacterial or fungal growth. Sometimes multiple sites may also be sampled. [citation needed] Types of samples include the following: