Should yeasts in respiratory secretions be identified?

Four hundred forty samples of sputa and bronchial washings were examined microscopically for evidence of pulmonary and oropharyngeal secretions. Most (88%) sputa showed definite evidence of oropharyngeal contamination, whereas bronchial washings showed much less frequent (21%) contamination. Culture results of the same specimens showed that yeasts (excluding dimorphic fungi) were recovered from 74% of the sputa and 25% of the bronchial washings. It seems that microscopic evidence of oropharyngeal contamination is a reliable index for predicting the presence of yeasts in respiratory secretions. Their presence in cultures of respiratory secretions probably represents "normal flora" except for Cryptococcus neoformans, and their routine identification is not warranted.