Respiratory Cultures: Screening Criteria
Last modified by
mike_rogers
on
March 16, 2009 02:46 PM
|
UNC Hospitals McLendon Clinical Laboratories 101 Manning Drive Chapel Hill, NC 27514 |
Sputum and Tracheal Aspirate specimens are subject to screening for specimen acceptibility, including those from Transplant patients. Unacceptable specimens are rejected for culture, and the results of the unacceptable screening smears are called to the ordering physician, or to the patient's nurse. Specimens from Transplant patients are not rejected, but are reported with the comment "Smear Results Suggest Poor Specimen Quality".
To increase the likelihood of obtaining an acceptable specimen, please review Sputum Collection Methods prior to obtaining specimen.
The following criteria are used to determine acceptance or rejection, using a Gram-stained smear of the specimen:
| PMN/Low Power Field | Squamous Epithelial Cells/Low Power Field | Acceptable? | Comments |
| <10 | <10 | NO | Gram-stain does not suggest ongoing inflammatory process; Specimen processed by request only for neutropenic patients (ANC <0.5). |
| 10-25 | <10 | YES | If No Organisms are Seen (on Oil Immersion) the Ordering Physician or Nurse is contacted: Specimen is Unacceptable due to Low Culture Yield. If yeast are the only organisms observed (on oil immersion) the ordering physician is contacted to determine need for culture. |
| >25 | <10 | YES | |
| >25 | 10-25 | YES | |
| OTHER | NO | ||
| Adult Patients (>16 y) | <10 white blood cells/LPF unless the patient is neutropenic OR No Organisms Seen on Oil Immersion | Unacceptable |
| Pediatric Patients (<16 y) | No Organisms Seen on Oil Immersion OR <10 white blood cells/LPF unless patient is neutropenic | Unacceptable |
| All Patients | Other than Above | Acceptable |
