[Bacteriological examination of the sputum in support of a rational antibiotic therapy of bronchopulmonary infections].

An algorhythm of bacteriological investigation of the sputum is suggested for the etiological diagnosis of acute bronchopulmonary infections with pathogenically-conditioned bacteria. This investigation avoids misleading results, and provides, in a minimal time interval, both the first empiric criteria for the application of antibiotherapy--a definition of the microscopy category of the infecting pathogenically-conditioned bacteria--, and the second one, namely the antibiogram of the primary culture. This algorhythm is based on: decontamination of the sample by repeated washings; microscopical screening of the sample's quality, according to the ratio between inflammatory cells, squamous epithelial cells and the fibrin exudate; the qualitative bacterioscopic examination; the semi-quantitative culture of the sputum with the antibiogram on the primary culture; identification of infecting pathogenically-conditioned bacteria by confrontation of the microscopic significant amounts; inflammatory cells on the smear prepared directly from the sputum; the antibiogram on sub-cultures of the infecting, pathogenically-conditioned bacteria. Of high significance for the etiologic implication is the association of the inflammatory cells in quantities equal or greater than 13 organisms per microscopic field of pneumoncocoid bacteria, equal or greater than 20 organisms per microscopic field of the haemophilloid germs (with a significance threshold of 5%), and equal or greater than 18 organisms per microscopic field of neisseroid germs (at a significance threshold of 0.27%).