Chapter 6:	Sputum Examination
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When the presence of a bacterial infection is suspected in a patient being examined, it is necessary to perform gram stain and culture of that sputum to evaluate what type, if any, of antibiotics should be prescribed to the patient. How the patient’s sputum is collected is crucial to obtaining valid test results. Procedures to be followed in order to ensure the integrity of the sputum collected for gram stain and culture include:

• Collect the sputum specimen as soon as the patient awakes in the morning, but after they have performed oral hygiene.

• Have the patient cough up the specimen into a container that has been sterilized, or use a suction catheter with a Luken’s trap to obtain the specimen.

Gross examination of the sputum should be performed, taking note of its color, odor, consistency, contents (such as foreign substances), and volume.

The sputum specimen is then stained and microscopically examined in the laboratory. Appropriate antibiotic therapy is prescribed when bacteria have been identified as being either gram positive or gram negative. Tuberculosis patients’ sputum should be evaluated with a Ziehl-Neelsen stain to identify any acid-fast bacilli.