Martín J E, Catalán P, Expósito C, Pérez M T, Domínguez J, Bisquert J
Sección de Microbiología, Hospital General y Docente del Instituto Nacional de la Salud, Guadalajara.
Enferm Infecc Microbiol Clin. 1991 Dec;9(10):603-7.
We compare five selection criteria to discriminate between good quality expectorated sputum and specimens contaminated with upper respiratory tract secretions. We employed two microscopic methods (Bartlett, Heineman) which rely upon the number of squamo-epithelial cells and polymorphonuclear leucocytes; and a macroscopic method (the Medical Research Council) which evaluates the gross appearance of sputum, with three different criteria for admission established by our own. Three hundred and thirty two sputum were included. We evaluated sensitivity, specificity and predictive values as compared with isolation or not of a potential pathogen. We obtained 72% and 45% sensitivity, and 81% and 86% specificity for Bartlett and Heineman methods respectively. Most restrictive criterion for macroscopic method provided 57% sensitivity and 82% specificity; least restrictive showed 97% sensitivity and 17% specificity. Macroscopic method is a quick, valuable screening for discarding sputum contaminated with upper respiratory tract secretions.
我们比较了五种选择标准，以区分高质量的咳出痰液和被上呼吸道分泌物污染的标本。我们采用了两种显微镜检查方法（巴特利特法、海涅曼法），这两种方法依赖于鳞状上皮细胞和多形核白细胞的数量；以及一种宏观检查方法（医学研究委员会法），该方法评估痰液的总体外观，并采用了我们自己制定的三种不同的入选标准。共纳入332份痰液样本。我们根据是否分离出潜在病原体评估了敏感性、特异性和预测值。巴特利特法和海涅曼法的敏感性分别为72%和45%，特异性分别为81%和86%。宏观检查方法中最严格的标准敏感性为57%，特异性为82%；最宽松的标准敏感性为97%，特异性为17%。宏观检查方法是一种快速、有价值的筛选方法，可用于丢弃被上呼吸道分泌物污染的痰液。
