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Sputum Test submissions and outcome results

MAC & Bronchiectasis | Last Active: Feb 26 7:09pm | Replies (81)

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Profile picture for Sue, Volunteer Mentor @sueinmn

@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.

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Replies to "@akron3 Sometimes there just isn't a shortcut! Here is the testing sequence and why it takes..."

@sueinmn Sue...if you are comfortable answering this.
Background Info: As you know I have not started the antibiotics and overall I am doing fine except for having that sensation of mucus (I assume it is mucus) stuck in my throat that is so annoying that I clear almost all day long. The only med or medical prescription I take/use is the saline for nebulizing.
I have had a couple sputum tests indicating negative for bacteria, positive for bacteria, negative for bacteria. I know it can go back and forth and probably for different reasons.
I like to send them monthly to stay on top of what might or might not be happening...my way of being proactive in my mind.
The local pulmonologist, so it appears at this point, will not allow an open order for a monthly submission as I have had with Tyler. I am in discussion with him about it all at this point. He apparently feels that if I won't do the med's there is no need to send sputum as I am requesting. We have not discussed as yet how often he will approve.

My question: How often do you send sputum for testing and what do you know about when it is necessary to send the sputum monthly?
Barbara

@sueinmn Dr Winthrop at OHSU told me they now have a blood test that can detect the DNA of MAC, so soon they will be able to monitor the presence and amount of infection without the sputum samples which can be hard to get, and come places in the lungs which may or may not have MAC, as it is not necessarily evenly distributed. I just started on the two drug treatment and agreed to participate in a study where they are testing to see if they can detect the decline of MAC via the blood tests. If this works it will be a great thing for all of us! No more struggles to get the right sputum sample and long waits for the results.
Anna