Sputum Culture- What does AFB Smear Positive mean?

Sorry I missed the first question. Doing this on my phone in a car. I don't know whether you can send a sample without the doctor's order. But most likely the one you do in clinic is sent out anyways. Only a very limited number of labs grow sputum cultures. And sampling error can and does happen with any lab. That
is why you submit 2 or 3 separate samples each time.
Blood cultures are not cheap and I'm sure insurance won't pay without a doctor's order.
I hope this helps ease your mind
Sue

Thank you Sue. When you mentioned 2 or 3 separate samples each time means, sending (3) cups to the same lab? I'm always sending sputum in only 1 cup that is provided by the doctors' office. The lab does culture, fungus and AFB. I have only been sending 1 sample to the lab every 6 weeks.

Yes, indeed I mean 2-3 specimen cups, collected on consecutive days being sent to the lab. That is the accepted standard.
Sue

Just received test results from last week 3+ acid fast seen.
Last month no acid fast seen. What does this mean?

This means more bacteria was seen on the slide where they do the preliminary test. Now they will send the sample to be cultured and see what grows. This may indicate there was some contamination of the slide (not uncommon) or they got more or less actual sputum (as opposed to the intermixed saliva) on the slide, or the amount of mycobacteria in your lungs is not declining.
What comes back from the culture should lead the pulmonologist to the "next step" if you have been on the antibiotic for 6 months or longer.

Take a look at this video, at 23:00 minutes, for the latest in treatment choices for MAC that isn't improving after 6 months of antibiotics:

Sue you mentioned that blood cultures are not cheap- my doctor never mentioned a possibility of blood cultures; are there any?
thank you

Sorry, my mistake. Sputum cultures are not cheap. They require weeks of monitoring in a specialized lab under strict controls. A blood culture would not be superior to a sputum culture - in fact, it would not show NTM unless you have a systemic infection - virtually unheard of except in severely immunocompromised patients like those with active AIDS or people who have been irradiated and are awaiting bone marrow transplants.
Sue

Thanks it makes sense

Tell me more about collecting on 3 consecutive days. No one at my Mac/Bronch Clinic ever mentioned this! Always said “just deliver a sample to us.” So do you use the Specimen Collection cups? I never know if I’m going to produce a good deep lung sample, so when I nebulize I spit into a new 3oz plastic cup. If it’s a good sample, could I pour that into a specimen cup? And then refrigerate until I have 3 to deliver? This may be the most important post I’ve read!
Thanks.

Interesting. So glad you have volunteered your time to this project Sue. Thanks for all the time you put into it, it is appreciated. Hope all is good for you this month/week!!!
Now that I think about it that is what they requested of me the week I was at NJH in October during my first visit there, and as well one sputum test sent in a few weeks before my first appointment there.... and before all the other tests given once I was there.
I just sent one cup in as requested by UT. Changed from NJH to UT due to the distance and the good reviews of the doctor who is there at UT with the BE program. So your response means I need to clarify why only one vs. three days of consecutive collecting. I will also be seeing an ID doctor who is local here in OKC for the first time, I asked my PCP for a local ID doctor . Apparently the OKC ID doctor does have other BE patients. So per your reply Sue .....a good question to ask about the sputum specimens and what lab is used when doctor(s) request sputum samples for testing.