The document discusses sputum examination and sputum smear microscopy. Sputum is mucus coughed up from the lower airways that is used for microbiological and cytological investigations of respiratory infections and systems. A good sputum sample is purulent with white blood cells, debris and viscous liquid. Sputum collection and smearing procedures are outlined as well as staining techniques like fluorescent staining for acid-fast bacilli examination to detect infections like tuberculosis. The standard operating procedure for sputum smear microscopy and common bacteria detected from cultures are also summarized.

1. SPUTUM
EXAMINATION
PRESENTED BY:
 MARTEY ALFRED

2. OBJECTIVES
WHAT IS SPUTUM
PHYSICAL DESCRIPTION OF A GOOD SPUTUM
SPUTUM COLLECTION PROCEDURE
SPUTUM AFB
STANDARD OPERATION PROCEDURE FOR SPUTUM
SMEAR MICROSCOPY
COMMON PROCEDURES FOR SPUTUM SMEAR
MICROSCOPY
AFB STAINING TECHNIQUES USING THE FLOURESCENT
METHOD
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3. SPUTUM
Sputum is mucus that is coughed up from the lower
airways. This process is known as sputilization. In
medicine, sputum samples are usually used for
microbiological investigations of respiratory infections
and cytological investigations of respiratory systems.
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5. Physical description of a good sputum
Purulent sputum contains pus,
composed of white blood cells,
cellular debris, dead tissue, serous
fluid, and viscous liquid (mucus).
Purulent sputum is typically yellow
or green. It is seen in cases of
bronchitis or acute upper
respiratory tract infection
(common cold, laryngitis).
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6. A bacterial sputum culture is used to detect and
diagnose bacterial lower respiratory tract infections
such as bacterial pneumonia, Emphysemia and
bronchitis. It is typically performed with a Gram stain to
identify the bacteria causing a person's
infection(Sabatine, 2014).
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8. When is it ordered?
A bacterial sputum culture is ordered when a health practitioner
suspects that someone has a bacterial infection of the lungs or
airways(American Association of Clinical Chemistry, 2014).
Symptoms may include:
Cough
Fever
Muscle aches
Fatigue
Trouble breathing
Chest Pain
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9. What does the test result mean?
Microbiological sputum samples are usually used to look
for infections by Moraxella catarrhalis, Mycobacterium
tuberculosis, Streptococcus pneumoniae, and
Haemophilus influenza.
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10. The most common cause of bacterial pneumonia
in adults in the U.S. is Streptococcus pneumoniae
(pneumococcus)(Kämpe, 2013). Other common bacteria
include:
Staphylococcus aureus (staph)
Haemophilus influenzae
Moraxella catarrhalis
Klebsiella pneumoniae
Streptococcus pyogenes
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13. Standard operating procedures for
sputum smear microscopy
Numbering on a slide
Smearing sputum on the slide
1. Break a wooden applicator into two pieces to make one end
rough
Length of the stick should be at least 10cm
2. Pick sputum from the most muco-purulent part of the wooden
applicator
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14. 3. Gently spread the sputum in the centre of the slide in a uniform
manner to get the size between 1x2cm and 2x3cm circular shape.
4. Allow the smear to dry completely
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15.  Fixing the smears
•With a forceps, hold the slide and pass it over a flame
2-3times
• Do not over heat or burn the smear
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16. SOME COMMON METHODS FOR SPUTUM SMEAR
MICROSCOPY
Complete Blood Count
AFB staining techniques
•Ziehl-Neelsen Method
•Fluorescence Method
Bacterial sputum culture
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17. PROCEDURE USING FLUORESCENT METHOD
AURAMINE STAINY OF SLIDE
1. Arrange slide in serial order on stainy bridge with the
smear up
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18. 2. Apply filtered 0.1% Auramine on the slide and
keep for at least 25minutes
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19. 3. Rinse with water and drain.
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20. 4. Apply 0.5% HCL decolorizing solution for 3 minutes
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21. 5. Rinse with water and drain
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22. 6. Apply 0.5% potassium permanganate for 1 minute
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23. 7. Rinse with water and drain
8. Air dry on slide rack.
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24. Reporting format
X200 Magnification
(1line=2cm=30fields)
>100 AFB/ field on average (3+)
10-100 AFB/ field on average (2+)
30-299 AFB/line (1+)
1-19 AFB/line (scanty)
No AFB found/line (-)
(LeBlond, 2007)
EXAMINE
FLUORESCENT MICROSCOPE8/21/2015 Fenteng et al 2015 KOGH 5 24

25. X400 magnification
(1line=2cm=40fields)
>50 AFB/ field on average (3+)
5-50 AFB/ field on average (2+)
20-199 AFB/line (1+)
1-19 AFB/line (scanty)
No AFB found/line (-)
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26. CONCLUSION
Sputum is not sterile so when a person has an infection,
there will typically be pathogenic bacteria present.
Specific techniques are carried out to identify such
bacteria then antimicrobial susceptibility testing is
usually performed so that the appropriate antibiotics
can be prescribed(AACC, 2014).
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28. REFERENCES
1. Richard F.LeBlond. Diagnostics_expectoration. US: McGraw-Hill Companies, Inc.
ISBN 0-07-140923-8.
2. Richard F.LeBlond. Diagnostics_expectoration. US: McGraw-Hill Companies, Inc.
ISBN 0-07-140923-8
3. Richard F.LeBlond. Diagnostics. US: McGraw-Hill Companies, Inc. ISBN 0-07-
140923-8.
4. Uppsala Academic Hospital > Guidelines for treatment of acute lung diseases.
August 2004. Authors: Christer Hanson, Carl-Axel Karlsson, Mary Kämpe, Kristina
Lamberg, Eva Lindberg, Lavinia Machado Boman, Gunnemar Stålenheim
5. Sabatine, [edited by] Marc S. (2014). Pocket medicine (Fifth edition. ed.). [S.l.]:
Aspen Publishers, Inc. ISBN 1451193785
6. American Association of Clinical Chemistry, bing.com/AACC
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