Related Experiment Video
Updated: Aug 25, 2026
Quality-Controlled Sputum Analysis by Flow Cytometry
Published on: August 9, 2021
[The value of proper sputum collection instruction in detection of acid-fast bacillus]
Tetsuhisa Hirooka1, Takeshi Higuchi, Nakako Tanaka
1Clinical Laboratory, Osaka Hospital, Anti-Tuberculosis Association Osaka Branch, 2276-1, Neya, Neyagawa-shi, Osaka 572-0801, Japan. bisei@osaka-hospital.jp
Purpose:
This study was conducted to assess clinically whether intervention with instruction applying respiratory rehabilitation method for expectorating sputum was useful or not to obtain more suitable sputum for smear examination of acid-fast bacilli.
Subject:
All specimens examined were sputa obtained from 163 patients without the instruction group and 161 patients with the instruction group, who visited our outpatients clinic during one year from September 1, 2000 to August 31, 2001 and the following one year, respectively.
Method:
Gross appearance of the sputum according to Miller & Jones' classification (M1, M2, P1-P3) and smear positive rate by fluorescence staining method after N-Acetyl-L-cysteine-NaOH treatment and centrifugation were compared between the two groups.
Results:
M1 and P1 sputa were 21.5% and 21.5% in the no instruction group, while those were 8.1%, 36.6% in the instruction group. Difference in M2, P2 and P3 sputa were not significant between the groups. Smear positive rate was 10.4% in the no instruction group, while it was 21.1% in the instruction group. According to gross appearance of M2, P1 and P2, positive rate was 11.1%, 11.4% and 30.8% in the no instruction group, and 17.7%, 28.8%, and 26.3% in the instruction group. Chest roentogenographic findings judged by type (cavitary and non-cavitary) and extent of the pulmonary lesions of these smear positive cases (17 in the no instruction group and 34 with the instruction group), revealed that the no instruction group consisted of more predominantly severer disease with cavity and moderately or far advanced lesions as compared with the instruction group. CONSIDERATION: We could exclude that the difference in gross appearance and smear-positive rate of the sputum specimen between groups without and with the instruction might be due to differences in disease severity between the two groups with and without the instruction.
Conclusion:
The instruction for sputum expectoration seems to be useful to increase positive rate in the smear examination of acid-fast bacilli.
Related Concept Videos
01:26Sputum Studies I: Gram Stain, cytology, and Acid-fast smear and culture
Gram Stain
The Gram Stain is an integral part of sputum studies. It involves the staining of sputum, which permits...
01:20Sputum Studies II: Culture and Sensitivity
Sputum culture and sensitivity is a medical procedure used to diagnose bacterial infections in the respiratory tract and select the most appropriate antibiotics for treatment. This process involves analyzing sputum samples of thick and opaque secretions produced in the lungs and airways. These samples are collected from patients and then sent to the laboratory for analysis.
The test can identify various pathogens responsible for respiratory infections, including Streptococcus,...
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...