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Sputum screening by Nomarski interference contrast microscopy

D F Welch, M T Kelly

    Journal of Clinical Microbiology
    |April 1, 1979
    PubMed
    Summary
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    Nomarski interference contrast microscopy (NIM) offers a rapid and accurate method for sputum screening. This technique effectively differentiates cell types, improving the clinical relevance of sputum culture results.

    Area of Science:

    • Microbiology
    • Medical Diagnostics
    • Microscopy

    Background:

    • Sputum culture is crucial for diagnosing respiratory infections.
    • Microscopic examination of sputum aids in assessing specimen quality.
    • Traditional methods for sputum screening can be time-consuming.

    Purpose of the Study:

    • To compare Gram-stained smears with Nomarski interference contrast microscopy (NIM) for sputum screening.
    • To evaluate the efficiency and accuracy of NIM in enumerating squamous epithelial cells (EPC) and leukocytes (WBC).
    • To correlate sputum specimen quality, as determined by NIM, with the clinical relevance of culture results.

    Main Methods:

    • Sputum specimens submitted for culture were examined using both Gram staining and NIM.
    • NIM was used for rapid enumeration of EPC and WBC.

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  • Specimens were classified into three categories (Class I, II, III) based on cell counts.
  • Clinical relevance of culture results was assessed by reviewing patient records.

    • Main Results:

    • NIM provided comparable results to Gram staining but allowed for more rapid screening and easier cell differentiation.
    • Class I specimens (predominance of EPC) yielded only 30% clinically relevant culture results.
    • Class II specimens (mixed EPC and WBC) yielded 63% clinically relevant results.
    • Class III specimens (predominance of WBC) yielded 96% clinically relevant results.

    Conclusions:

    • NIM is a rapid, simple, and accurate method for sputum screening.
    • Sputum screening using NIM improves the assessment of specimen quality.
    • Microscopic classification of sputum specimens correlates strongly with the diagnostic value of subsequent cultures.