Bronchiectasis and lung infection

My pulmonologist has a supply of sputum cups in her office. You should not have to buy them!

It depends on what the pulmonologist orders (and codes) sputum test, sputum culture, colony count, sensitivity test...so they are the correct place to ask. Some state labs and NJH lab are set up to do colony counts; I understand most Quest labs are not - I don't know about others.

My doctor refused to test me several times over a long period of time as symptoms worsened. I now have a pulmonologist.
You could insist that your doctor either do the mucus sputum test or refer you to a pulmonologist who will ( if you don’t already have one).
Perhaps having someone attend the appointment with you might help? If you have ongoing symptoms or a serious flare up of Bronchiectasis, it is hard to imagine you would be denied a sputum culture test, but it happens. Sometimes a second opinion is warranted. Don’t let a doctor gaslight or intimidate you if you are ill.
Wishing you luck.

Currently on steroids and antibiotics for several weeks and it is too late to do a sputum test. He says it wouldn't do any good. He also says it is asthma and not my bronchiectasis so sputum wouldn't help. He is the top pulmo around here. He says he can tell by the sounds in my chest. I will ask again when I see him a month after this clears up.

Again, it is not sputum CUPS we are talking about. It is sputum TESTS.

Sputum tests are done to detect bacteria ( culture) or for mycobacteria

Yikes! Here is the current guideline for identifying and treating NTM:
https://ntminfo.org/wp-content/uploads/2020/07/NTMguidelines2020.pdf
Here is the deal - with bronchiectasis, your lungs are damaged so that it is hard to cure infections - my pulmonologist cannot tell with a stethoscope whether I have NTM/MAC, pseudomonas, aspergillus or nocardia infections. It takes: a sputum test, a sputum culture, a CT scan and a current health history (looking for fever, fatigue, cough, weight loss, night sweats...)

Sputum tests and cultures can be done while you are on antibiotics - that is how we tell whether or not the meds are working. If not working, sensitivity testing of the cultured germs is needed to see whether the meds need to be changed or increased. When on the NTM antibiotics, it is typical to submit a new specimen every 2-3 months, and if you don't clear in 6-9 months, a 4th med is often added or the dosage is increased.

All of this tells me you need a doctor more experienced treating Bronchiectasis and NTM - if you can let us know generally where you are, I am sure someone will have a suggestion. You can also self-refer to National Jewish Health in Denver, Mayo in Minnesota or Florida, UT Tyler in Texas, Cleveland Clinic and a number of other centers that specialize.

Sue - Not sure I understand "sputum culture, colony count, sensitivity test".
Does each test for something different
or
do they all indicate the extent and degree of an infection (MAI/MAC etc. etc.) but have different ways of expressing the results???
Barbara

These are different steps in culturing the same specimen. The culture is grown for 4-8 weeks, then inspected under a microscope to see whether NTM is present, and what type. To a trained eye, the types look different; in some cases they can be further identified by genetic testing of the bacteria.
The next step is a "colony count" - if not requested, a number is not expressed - usually recorded as few, some, many...A more exact method is to count the number of NTM colonies growing on the specimen, which is expressed by some labs as an absolute number, and others on a scales (meaningful to your doc as +1 thru +5). This helps indicate the severity of infection, and can help the doc decide whether antibiotics are needed immediately or you can "watch & wait", and sometimes whether Arikayce should be added right away.
The final step is sensitivity testing - antibiotics are applied to the colonies to see which are effective against your "bugs" so the treating doc can decide which ones to use.

Sue-
Thanks for the detailed explanation. You have learned so very much in what I would consider a reasonably short time, from the time you were finally diagnosed with BE, the infections and the go round of antibiotics.
So far with two different results, one of my cultures received a statement of 7 Colonies and the following months's submission to Tyler stating the +1 both for MAI complex. Here's hoping I am doing right by myself with what I am doing to keep me from hearing....."we need to put you on anti-biotics." As I said before, that will require great thought, a well thought out decision, to start the rountine of antibiotics at my time in life. Now at 81 and 10 months into life. Hope your Sunday is filled with all enjoyable activities.!