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NTMs in sputum samples: is it really reliable for therapy monitoring?
MAC & Bronchiectasis | Last Active: Nov 11 6:08pm | Replies (14)Comment receiving replies
Does anyone know a trick for getting a sputum sample? (Or could someone help me find the answer if it has already been posted somewhere. I'm not great with technology.)
I am having trouble getting a sputum sample for my doctor. I was diagnosed in around 2015 with NTM, and developed cavities and nodules. To monitor my condition, the doctor needs more sputum samples. 1 sample showed no MAC following months of treatment with amikacin, ethambutol, rifabutin, and clofazimine, and the 2nd sputum also has no MAC showing, but it was given after I nebulized saline, so doc didn't know if that would be a true reading (saline may kill micro- bacterium). I don't cough stuff up until after I nebulize, and sputum produced that way may give a false reading.
Best regards to all of you battling this illness!
Mokie
Replies to "Does anyone know a trick for getting a sputum sample? (Or could someone help me find..."
@mokie @reneemc An induced sputum sample is done in office if someone has a difficult time producing a sputum sample. 7%+ saline is generally used. So I would think that the hyper saline does not change the sputum significantly. My understanding for monitoring MAC et al., comes down to not only frequent sputum samples but also radiology (CT scans) and clinical symptoms.
7% saline by itself does not kill pathogens but it creates an environment that makes it harder for bacteria to thrive. Inhaled saline helps with clearance, which reduces bacterial load. The bacteria are sneaky and can form biofilms making them resistant to antibiotics. So the more bacteria you can get rid of frequently the better.
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The saline can alter the sputum test results?