Sputum test
Sputum test

Sputum Gram stain

Definition:

This is a method of staining microorganisms (bacteria) using a special series of stains. In this test, a sputum specimen is examined under the microscope. Sputum is the mucous secretions produced by the lower respiratory tract.

The Gram stain method can be applied to almost any clinical specimen, and is one of the most commonly used techniques for the rapid diagnosis of bacterial infections.

Alternative Names:
Gram stain of sputum

How the test is performed:

A sample of sputum is applied in a very thin layer to a microscope slide -- this is called a smear. The specimen is stained with a series of stains, together called a Gram stain. It is first stained with crystal violet stain, then iodine, then decolorized, then stained with safranin.

The stained smear is then examined under the microscope for the presence of bacteria. The color, size, and morphologic appearance (shape) of the cells help make it possible to identify the infecting organism.

How to prepare for the test:

Obtain a sputum sample from your lungs by coughing a specimen of mucous from deep inside your lungs (not saliva or spit from the mouth) into a specimen container. If coughing does not produce sputum, a breathing treatment may precede the test to induce or encourage sputum production.

If you have a dry cough or are unable to produce a specimen, sometimes bronchoscopy is necessary.

How the test will feel:
The person needing the test will usually have a productive cough. Occasionally, the sputum is collected by bronchoscopy, and more discomfort is associated with this procedure.
Why the test is performed:
The test is performed when there is a persistent or prolonged cough, sputum has a foul odor or unusual color, respiratory disease is suspected, or there is a generalized infection.
Normal Values:
No presence of organisms is normal. The sputum is clear, thin, and odorless.
What abnormal results mean:
A bacterial infection may be present. The infecting organism(s) may be tentatively identified. Culture is needed to confirm the diagnosis.
What the risks are:
There are no risks unless a bronchoscopy is used to obtain the specimen.
Special considerations:
The test may need to be repeated if the specimen produced contains only saliva from the mouth.

Review Date: 1/7/2002
Reviewed By: Camille Kotton, M.D., Infectious Diseases Division, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.
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