Sputum Quality Assessment Regarding Sputum Culture for Diagnosing Lower Respiratory Tract Infections in Children

Gorica Popova; Katerina Boskovska; Ivana Arnaudova-Danevska; Olga Smilevska-Spasova; Tatjana Jakovska

doi:10.3889/oamjms.2019.551

Authors

Gorica Popova Department of Clinical Microbiology, Institute for Respiratory Diseases in Children, Skopje, Republic of Macedonia
Katerina Boskovska Pediatric Department, Institute for Respiratory Diseases in Children, Skopje, Republic of Macedonia
Ivana Arnaudova-Danevska Pediatric Department, Institute for Respiratory Diseases in Children, Skopje, Republic of Macedonia
Olga Smilevska-Spasova Pediatric Department, Institute for Respiratory Diseases in Children, Skopje, Republic of Macedonia
Tatjana Jakovska Pediatric Department, Institute for Respiratory Diseases in Children, Skopje, Republic of Macedonia

DOI:

https://doi.org/10.3889/oamjms.2019.551

Keywords:

Sputum culture, Quality assessment, Streptococcus pneumoniae, Escherichia coli

Abstract

BACKGROUND: The clinical relevance of specimens from the lower airways is often debatable. However, they are most commonly examined for diagnosing lower respiratory tract infections (LRTIs).
AIM: This study aimed to determine the diagnostic value of sputum quality assessment about sputum culture for diagnosing LRTIs in children.
METHODS: In six months, a total of 1485 sputum samples were quality assessed by using Bartlettâ€™s grading system. All samples, regardless of their quality, were cultured, identified, and antimicrobial susceptibility testing was performed by Kirby-Bauer disc-diffusion method.
RESULTS: Among the acceptable category, defined by Bartlettâ€™s grading system, 132 (63.2%) samples showed culture positivity of which Streptococcus pneumoniae 48 (36.4%) was most commonly isolated, followed by Moraxella catarrhalis 22 (16.7%) and Haemophilus influenza 21 (15.9%). Among the non-acceptable category, 185 (14.5%) samples were culture positive of which most commonly isolated were Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa with 64 (34.6%), 54 (29.2%) and 28 (15.1%), respectively.
CONCLUSION: Sputum quality assessment is a useful tool for distinguishing the true respiratory pathogens from possible colonising flora for which antibiotic treatment should not be highly considered.