Sputum Test submissions and outcome results

@pacathy
Thank you

@blm1007blm1007 I absolutely agree with you! When I first started this journey in 2017, I was told that my sputum cultures were gonna take at least six weeks because that’s how long it took to properly culture them and watch them grow. Now they send them to some lab downtown and they’re back the next day! What is that?! I believe my infectious disease doctor has gotten very sloppy and I do not appreciate her lackadaisical attitude. And then the opposition between her and the pulmonologists, it’s just ridiculous that we as patients are supposed to figure this out as to who knows what’s right? I personally have had enough and this is why I’m going to NJH.
Initially, my PCP was absolutely wonderful! He was on top of it every minute of the day. He had me do a culture at least every three months, a CT scan every three months come to see him every two months, he was on top of it. Since then I’ve had to really advocate for myself.
Thank you so much for reaching out! I wish you all the luck in the world and I’m so glad at NJH. Which campus are you going to?

@blm1007blm1007 & @kathyjjb My pulmonologist told me that with MAC/NTM "everywhere" it is not unusual to have very small amounts show up in my culture.
I have had 3 "positive" cultures since 2020 out of more than 12, but none with a significant amount of NTM. In 2 cases, where I submitted 2 cultures together, one was positive and the other negative. My last 2 samples, submitted at the same time, showed "positive" on the slide, but nothing grew on the long culture - we attributed that to probable contamination from saliva or environment.

I have an open order for sputum cultures, and vials at home, so I can submit samples whenever my mucus increases.

@sueinmn doesn't it take 6 wks to get a sputum diagnosis? or is there somewhere where one could get it done faster? I really hate that long wait

@sueinmn doesn't it take 6 wks to get a sputum diagnosis? or is there somewhere where one could get it done faster? I really hate that long wait

@akron3 Sometimes there just isn't a shortcut!
Here is the testing sequence and why it takes so long. Let's begin with the caveat that most strains of mycobacteria a very slow-growing, many that may be present in our cultures do not require treatment, and those strains that require antibiotic therapy are "picky" - only a few drugs are capable of killing them.

Sputum sample is produced, then stained in the lab to see if there are suspected mycobacteria present. If the result is "positive" the sample is then stabilized and sent to a specialized lab for further testing. Some labs send their samples to a central location for processing, some are sent to specific commercial labs, and some are sent to the lab at National Jewish Health (NJH) in Denver. As far as I know, all are reliable, but only NJH and a few other locations have the capability of reporting the count (or density) of the bacteria, which, along with other symptoms, can help the doctor in determining the severity of infection.
The sample is place on several culture plates and incubated for at least 4 weeks to see if a mycobacteria grows. It is then examined every few days for up to 8 weeks to see what grows.
If something grows, a technician examines the sample under a microscope, or sometimes with genetic tests, to see exactly what it is.
Once that is determined, specific antibiotics are applied to the slide(s) to see which ones kill the bacteria, or al least keep it from growing.
So, as you can see, the "bug" runs the show, and determines how long it takes to get results. When I was first diagnosed, the infection was so massive that it only took 4 weeks to determine I had MAC, and one more to determine which meds to use. The last time they grew my culture all the way, it took 8 weeks, and the only bacteria that grew were of a variety not treated.
All that said, research is underway to find a faster, but still affordable way to speed up the process. This is only beginning clinical trials, so we are probably looking at a few years...not months...before we see a change.

@kathyjjb Every lab, test protocol and lab report seem to differ differ. I am not a doctor, so I have no idea and rely on my pulmonologists and their excellent staff. Right now, I am trying to figure out why Quest Diagnostics is taking 5 days to report on a test that takes 24 hours at my home clinic...sigh.

@sueinmn I am curious to know how you get results from Quest in 5 days, or 24 hours at home. Is it just the smear test? What are you testing for? I do sputum samples monthly and it can take weeks for when they grow a culture to find MAC, but of course the smear test is quite quick. My smear test is almost always negative, while the culture has come back positive only once (even though the smear was negative).

Thanks!

@akron3 Sometimes there just isn't a shortcut!
Here is the testing sequence and why it takes so long. Let's begin with the caveat that most strains of mycobacteria a very slow-growing, many that may be present in our cultures do not require treatment, and those strains that require antibiotic therapy are "picky" - only a few drugs are capable of killing them.

Sputum sample is produced, then stained in the lab to see if there are suspected mycobacteria present. If the result is "positive" the sample is then stabilized and sent to a specialized lab for further testing. Some labs send their samples to a central location for processing, some are sent to specific commercial labs, and some are sent to the lab at National Jewish Health (NJH) in Denver. As far as I know, all are reliable, but only NJH and a few other locations have the capability of reporting the count (or density) of the bacteria, which, along with other symptoms, can help the doctor in determining the severity of infection.
The sample is place on several culture plates and incubated for at least 4 weeks to see if a mycobacteria grows. It is then examined every few days for up to 8 weeks to see what grows.
If something grows, a technician examines the sample under a microscope, or sometimes with genetic tests, to see exactly what it is.
Once that is determined, specific antibiotics are applied to the slide(s) to see which ones kill the bacteria, or al least keep it from growing.
So, as you can see, the "bug" runs the show, and determines how long it takes to get results. When I was first diagnosed, the infection was so massive that it only took 4 weeks to determine I had MAC, and one more to determine which meds to use. The last time they grew my culture all the way, it took 8 weeks, and the only bacteria that grew were of a variety not treated.
All that said, research is underway to find a faster, but still affordable way to speed up the process. This is only beginning clinical trials, so we are probably looking at a few years...not months...before we see a change.