Have you been asked to do a sputum culture? Let's talk about this in detail!

You may have been asked by a doctor to do a sputum culture. Or you may have heard about it somewhere. I understand that you have a lot of questions in your mind, such as what is it, why is it done, and how is it done. Don't be afraid of anything, let's talk about everything clearly and simply.

What is sputum? Why is it different from saliva?

First, let's look at what sputum is. Simply put, sputum is a thick secretion that forms inside your lungs. It's like phlegm, but thicker and comes from deep inside your lungs. Some people call it "phlegm" and some people call it "phlegm."

The important thing is that mucus is not the saliva (`Saliva` or `Spit`) in your mouth. Saliva is produced by glands in your mouth. But mucus comes from your lungs. If you have an infection in your lungs or respiratory tract, or a long-term illness (`Chronic illness`), you may have mucus. This mucus also contains immune system cells that fight germs in our body. The mucus is thick, so germs stick to it, and then the tiny hair-like parts (`Cilia`) in our respiratory tract push this mucus up and out through the mouth. That's what comes out when we cough.

When is a sputum culture done?

Now you understand what a sputum test is. So why do we do this sputum test? Doctors use this test for several main reasons:

1. Make a diagnosis (Diagnosis)

This test is often done to find out if you have an infection in your lungs or respiratory tract, and if so, what type of germ (bacteria or fungus) is causing it. Here are a few examples:

• Pneumonia: This is a serious lung infection. It is a leading cause of death worldwide.
• Tuberculosis (TB): This is also an infection of the lungs caused by a specific bacteria. If not treated properly, it can spread to other parts of the body.
• Bronchiectasis: This is a condition in which the airways become narrowed and the function of the lungs decreases.

Important: Doctors usually do not do this test if you think you have a viral infection. They only do it if they suspect a bacterial or fungal infection.

2. Plan treatment (Treatment)

Knowing exactly what germ is causing the infection makes it easier for your doctor to choose the right treatment. Sometimes, this test is also used to see which drugs the germs in your sputum sample are sensitive to and which drugs will not kill them (`susceptibility testing`). This will help avoid wasting time by giving the wrong medication.

3. Monitor the situation (Monitoring)

When you are being treated for a lung infection, doctors also use these sputum tests to see how effective the treatment is and whether the disease is improving or worsening.

Why do I need this test? What symptoms should I have?

If you have symptoms of a serious lung infection, such as pneumonia, your doctor may order this sputum test. What are these symptoms?

• If you have a cough that produces mucus .
• If you have a fever or chills .
• If you have difficulty breathing (dyspnea) .
• If you experience chest pain when taking a deep breath or coughing .
• If you feel tired all the time .
• Confusion , especially in an elderly person, if present.

If you have symptoms of a respiratory infection like this, your doctor will usually first do a chest X-ray or CT scan. If those tests show a lung infection, they will order a sputum test to find the cause.

There are other times a doctor may request this test:

• If your symptoms are severe enough to require hospitalization .
• If you have other chronic medical conditions (e.g. diabetes, heart disease), which put you at higher risk of developing serious infections.
• If the doctor suspects that this is a bacterial or fungal infection (and not a virus),

How is this test done?

To do a sputum test, your doctor will need a sample of your sputum. The lab will need a large amount of sputum to test. There are two main ways to obtain this sputum sample:

1. The phlegm cup method: This is the most commonly used and easiest method. You are told to cough deeply and then put the phlegm into a special cup.

2. Bronchoscopy: Sometimes, if you have difficulty clearing your mucus, your doctor may need to do this procedure. In this procedure, a flexible tube with a small camera is inserted through your mouth or nose, into your lungs, and a sample of mucus is taken directly from there.

After the sputum sample is taken, it is sent to a lab. At the lab, a pathologist or other lab technician places the sputum sample in a special dish with a medium that is used to grow germs. If the sputum contains bacteria or other germs, the medium will help them grow. After about a day, the pathologist will examine the sample to see what kind of germs have grown and how many.

How to prepare for the test?

If you are going to have a phlegm collection, your doctor will probably tell you to drink plenty of water the night before the test . This will help you expel the phlegm more easily. You may also be asked not to eat anything for an hour or two before the test. This test is usually done in the morning, because the phlegm is most concentrated at that time.

If you are having a bronchoscopy, your doctor will tell you to fast for about 12 hours before the test. This means you cannot eat or drink anything except water. If you are taking any blood thinners, you will need to tell your doctor about them, and they may ask you to stop taking them for a few days. You will also be asked to bring someone to drive you home after the test, as it may be difficult for you to drive.

What can you expect during the test?

Your feelings may vary depending on the test method.

Method of giving a thin layer of mucus:

Before taking the sputum sample, you will be asked to rinse your mouth with water. Then, the doctor or nurse will ask you to take a few deep breaths. Then, they will ask you to cough loudly for a few minutes, then put the sputum into the cup. You may need to do this several times until you have collected a large amount of sputum.

To help remove phlegm, your doctor may also do the following:

• You can tap your chest , the mucus in your lungs will loosen up.
• You can inhale a salty mist , which will help to expel mucus more easily.

Bronchoscopy test:

If you are unable to clear a large amount of mucus, the doctor will perform a bronchoscopy. First, they will give you medicine to relax . Then, they will give you anesthesia so that you don't feel any pain.

The doctor inserts a thin, lighted tube through your nose or mouth and into your lungs and airways. The tube has a small camera on it, so the doctor can see inside. The doctor uses a small brush or suction device to take a sample of mucus.

When you have this `(Bronchoscopy)`, you may feel a little pressure because of the tube, and you may have a little difficulty breathing. But you won't feel any pain , because you've been given a numbing medicine.

What happens after the test?

After the cough is relieved, you may have a cough for a while, which will make you feel a little uncomfortable.

If you have had a bronchoscopy, it will take two to three hours before you can cough normally. You will not be able to eat or drink anything until then. Also, your throat may feel sore and sore for a few days.

Are there any risks to this test? What are the side effects?

Honestly, there's not much risk in getting a smear test.

In the case of the sputum removal method, a slight discomfort due to the constant coughing is a side effect. If a bronchoscopy is performed, the throat may be sore for a few days.

What are the results like? What do they tell us?

Sputum test results from the lab generally come in two types:

• Normal / Negative: The result is normal, or negative, meaning that no harmful bacteria or other germs were found in your sputum sample.
• Abnormal / Positive: An abnormal, or positive, result means that a potentially harmful bacteria or other germ was found in your sputum sample. The report will also include the name of the germ found and how many were present.

If you get an abnormal result, it could mean that you have a lung infection, such as pneumonia or tuberculosis. However, the results of the sputum test alone cannot tell for sure that you have an illness. The doctor must analyze these results very carefully. He or she will consider several other factors along with these results:

• Your health condition and symptoms .
• The type and amount of germs present in the sputum sample.
• Results of other tests, such as the Gram stain test.
• The quality of the sputum sample you provided (if only saliva was provided, if it is not the right amount of sputum, the results may be incorrect).
• Are you hospitalized ?

How long does it take to know the results of the test?

In the lab, it takes time for bacteria or other germs to grow. The pathologist usually doesn't look at the culture for at least 24 hours. So, it can take a few days for the results of your swab test to come back. Your doctor will call you to tell you about the results. They may ask you to come in to see the doctor, or they may tell you over the phone, or they may let you see the results online (in your electronic health record).

If the results are abnormal, what happens next?

If your results are abnormal, it means you may have a bacterial or fungal infection. Your doctor will need to do more tests to find out exactly what kind of infection you have. Or, you may have a flare-up of a long-standing condition, such as Chronic Obstructive Pulmonary Disease (COPD) or Cystic Fibrosis (CF). Your doctor will talk to you about the results and explain what to do next.

What times do you need to call the doctor ?

If your doctor had to do a bronchoscopy to collect your phlegm, it's normal to have a sore throat for a few days after the test. But if the soreness persists, or if you experience anything else unusual (e.g., high fever, difficulty breathing), be sure to call your doctor .

The most important things to remember (Take-Home Message)

Okay, I hope you now have a better understanding of a sputum culture.

Simply put, this is done to find out if you have an infection in your lungs or respiratory tract and what is causing it.

Although it may seem like a simple matter to collect mucus in a cup, you may be a little nervous about having a bronchoscopy. But your doctor will try to put you at ease and make it as easy as possible. If you have any questions about this test, don't hesitate to talk to your doctor. He or she will explain everything to you in more detail.

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