What am I doing wrong? How to get a good sputum specimen for a culture

Posted by pled @pled, Nov 28, 2023

Although I have tried several times, I have not been able to submit a sputum sample that meets the qualifications for testing. In the beginning it was because I was just dry coughing all the time and I basically gave up. But recently, by using postural drainage techniques I am able to cough up mucous in the evenings. My most recent sample came back "unacceptable for culture due to oropharyngeal contamination". I'm looking for tips on how to insure that my sample can be cultured in the future. Now that I'm actually coughing productively in the evenings, I am motivated to get this job done. How are you all accomplishing this?

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@afmustang

Sorry I can’t help you, but I’ll be happy to find a solution with you. I’m batting zero after 9 attempts and I have yet to find anyone who can definitively describe what an acceptable sputum sample looks like. I’ve wasted 4 months trying to determine what’s growing inside me. I’ll watch for an experienced response. Good luck to you.

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A good sputum sample will fill the bottom of the specimen cup, approx 5mL. Best samples are collected first thing in the morning as deep as possible from your lungs. The gunk. The lab does not want saliva. Too much saliva and it will be rejected. I know this only too well. Does this help you?

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I had to get a brochosphy to get my sputum up to check it and had mac. Using accapella and nebulizer 2x a day, need to cough up sputum it is a slow go, only doing it for 2 weeks. Wonder how long it takes and if it will happen. Brochosphy was a lot to go through

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@bonniesue

I had to get a brochosphy to get my sputum up to check it and had mac. Using accapella and nebulizer 2x a day, need to cough up sputum it is a slow go, only doing it for 2 weeks. Wonder how long it takes and if it will happen. Brochosphy was a lot to go through

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If you haven't watched this lecture on airway clearance, here it is. Highly recommended!
https://connect.mayoclinic.org/discussion/listen-to-dr-pj-mcshanes-recent-talk-on-airway-clearance/

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@sallyb827

I tried postural drainage several times for about 10 minutes and nothing happened. How long does it take? I am discouraged because I only get white stringy mucous up sometimes with little white chunks.
I have only gotten the one viable sputum test out of 3 attempts.
I do autogenic drainage and the aerobika. All suggestions welcome.

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Hi Sally,

I have had my sputum samples rejected as well and it's frustrating when you feel like you're trying everything to get a good sample. In addition to what you're already doing
taking the Mucinex beforehand might help to thin things out if you know you have to provide a sample the following day and like others have mentioned trying first thing in the morning.

Have you been going to the physician's office/lab for sputum induction or trying at home? Sometimes it's easier to take the cups home and then bring them the day of the appointment because it's more relaxed and you can really get into the different positions and really try everything.

When you're in your postural drainage position, you can also dry percussion using a cupped hand over the affected area.

Here is helpful information about positions and percussion: https://hopkinscf.org/wp-content/uploads/2019/06/postural_drainage.pdf

My right middle and right upper lobes are affected so after I nebulize, I lie flat and use my hand to percuss above my right breast and then lie on my side and percuss under my breast area and side. If I'm not coughing by this point, I'll do Autogenic breathing + Aerobika and try to wait to huff cough until after I've done all that.

Hope this is helpful!
Kate

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@kdiago1564

Hi Sally,

I have had my sputum samples rejected as well and it's frustrating when you feel like you're trying everything to get a good sample. In addition to what you're already doing
taking the Mucinex beforehand might help to thin things out if you know you have to provide a sample the following day and like others have mentioned trying first thing in the morning.

Have you been going to the physician's office/lab for sputum induction or trying at home? Sometimes it's easier to take the cups home and then bring them the day of the appointment because it's more relaxed and you can really get into the different positions and really try everything.

When you're in your postural drainage position, you can also dry percussion using a cupped hand over the affected area.

Here is helpful information about positions and percussion: https://hopkinscf.org/wp-content/uploads/2019/06/postural_drainage.pdf

My right middle and right upper lobes are affected so after I nebulize, I lie flat and use my hand to percuss above my right breast and then lie on my side and percuss under my breast area and side. If I'm not coughing by this point, I'll do Autogenic breathing + Aerobika and try to wait to huff cough until after I've done all that.

Hope this is helpful!
Kate

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Kate,
Thank you for all your suggestions!
Sally

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@kdiago1564

Hi Sally,

I have had my sputum samples rejected as well and it's frustrating when you feel like you're trying everything to get a good sample. In addition to what you're already doing
taking the Mucinex beforehand might help to thin things out if you know you have to provide a sample the following day and like others have mentioned trying first thing in the morning.

Have you been going to the physician's office/lab for sputum induction or trying at home? Sometimes it's easier to take the cups home and then bring them the day of the appointment because it's more relaxed and you can really get into the different positions and really try everything.

When you're in your postural drainage position, you can also dry percussion using a cupped hand over the affected area.

Here is helpful information about positions and percussion: https://hopkinscf.org/wp-content/uploads/2019/06/postural_drainage.pdf

My right middle and right upper lobes are affected so after I nebulize, I lie flat and use my hand to percuss above my right breast and then lie on my side and percuss under my breast area and side. If I'm not coughing by this point, I'll do Autogenic breathing + Aerobika and try to wait to huff cough until after I've done all that.

Hope this is helpful!
Kate

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Thanks for posting but the link did not work. I was able to find it, here it is. Looks very informative.
https://hopkinscf.org/wp-content/uploads/2019/06/postural_drainage.pdf

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