Screening of sputum: an experience in a tertiary care hospital

In order to reduce the work load on the clinical laboratory, it has been recommended that sputum samples, before accepting for culture, should be looked for the presence of polymorphs and squamous epithelial cells. (An appropriate sample should have more than 25 polymorphs per low power field and less than 10 epithelial cells per low power field; others are labelled as inappropriate). We examined this criteria for it's suitability on 1043 samples received at the clinical bacteriology laboratory at the All India Institute of Medical Sciences (AIIMS) for a period of one year (September, 1996 to August, 1997). Four hundred samples were found appropriate while 643 were inappropriate as per recommended criteria. Amongst the 400 appropriate samples, 215 were culture positive and 185 grew normal flora. However, we found that out of 643 inappropriate samples, 195 were culture positive (p < 0.01, statistically significant). The data was further divided into hospitalized and OPD cases. The distribution of culture positive cases in the appropriate samples was again found to be highly significant. It is apparent from our results that an attempt to process an inappropriate sample does not provide useful information.