What is sputum?
A sputum specimen is needed for identifying pathogens causing infection in the respiratory tract.
• The sputum is collected by coughing up, and is therefore contaminated with a small number of commensal micro-organisms from the upper respiratory tract and mouth.
• The
commensal micro-organism has to be differentiated from the pathogens causing infection.
• A sputum
sample is best collected in the morning after waking up.
• A clean container
with a wide mouth is used to collect sputum.
Types of collection of sputum in the laboratory.
o Spot
collection
o Early
morning sputum collection the next day.
Spot Collection (Immediate Specimen).
• Advise
patient to rinse mouth.
• Coach the
patient from behind.
• Instruct
the patient to cough sputum into the container.
o This
exercise should take place in a well ventilated environment preferably in the open
air/outdoors.
• Verify
that sample should contains sputum and not saliva.
• Send the
specimen to the laboratory.
• Send
patient home with a container for a first morning sputum the next day.
Early Morning Sputum Collection
This
collection happens during in Next day after collecting Spot collection.
Early morning sputum sample usually has the
highest yield of Acid Fast Bacilli.
• Instruct
the patient to produce early morning sputum just like it has been done today on
the spot collection.
• Emphasize
that the patient brings morning specimen to health unit within 24 hours after producing
the sample.
Precautions
during Collection of Sputum Specimen
• The
patient who is coughing is of a greater danger to staff than the specimen.
• When
collecting and receiving the specimen be sure to adhere to infection prevention
and control standards.
o Instruct
patient to cover their mouth when coughing.
o Do not
collect sputum in the laboratory or clinic room.
o Do not
stand in front of the patient during specimen collection.
o Use
appropriate leak proof containers with a wide mouth.
o Label a
clean sputum container (on the side and on the lid/cover) before obtaining specimen.
o Collect
specimen in a well-ventilated area, preferably outdoors in the sunlight.
o Ensure
that no one stands in front of the patient while producing sputum.
o Ensure
container is labelled and closed firmly with lid after the specimen is
collected.
o Wash your
hands with antiseptic after collecting specimen.
Transporting of Sputum Specimen
• Receive
the specimen from the patient.
• Assess for
its quality.
• Sputum
specimen can have various colours and aspects.
• If the
sample is liquid and clear without streaks of mucous materials, process the
sample but ensure that the poor quality of the sample is reported on the result
form. When possible, encourage the patient to collect the specimen again.
• Label the
container with infectious hazard marks and cover it well with a lid.
• If the
health facility does not have the diagnostic capacity, sputum samples should be
transported to the nearest diagnostic center as soon as possible, within four
days.
•
Transportation of sputum samples should be an immediate process.
• Samples
should be well packed and protected from direct light.
• Samples
should be accompanied by a well filled out laboratory record.
Key points:
- Sputum specimen is needed for identifying pathogens causing infection in the respiratory tract.
- Two sputum specimens (spot specimen and early morning sputum specimen) are usually needed for diagnosis of TB.
- Quality sputum sample relies on proper instruction to the patient about the procedure for sputum collection.
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