Tebbutt G M, Coleman D J
J Clin Pathol. 1978 Aug;31(8):724-9. doi: 10.1136/jcp.31.8.724.
Methods for the quantitation of leucocytes, squamous epithelial cells, and potential pathogens in sputa are described. Microscopic examination showed that 58% of sputa tested (554/957) were purulent or moderately purulent and 48% were moderately or heavily contaminated by squamous epithelial cells. The presence of squamous epithelial cells indicated oropharyngeal contamination. A simple dilution technique was chosen to compare the isolation of potential pathogens from direct cultures and from dilutions of sputa (10(-7) per ml original sputum). The dilution technique permitted easier reading of sputum cultures and avoided the possible over-reporting of enterobacteria and Pseudomonas aeruginosa, which were frequently found on direct examination. Enterobacteria and Pseudomonas aeruginosa were more likely to be isolated from sputa moderately or heavily contaminated with squamous epithelial cells. The use of counter-current immunoelectrophoresis (CIE) and co-agglutination tests to detect pneumococcal antigen in sputa is described. The presence of antigen in sputum was a more reliable index of lower respiratory tract infection than a positive culture. Co-agglutination tests were simpler to perform and used smaller amounts of expensive antiserum than CIE.
本文描述了痰液中白细胞、鳞状上皮细胞和潜在病原体的定量方法。显微镜检查显示，58%的检测痰液（554/957）为脓性或中度脓性，48%被鳞状上皮细胞中度或重度污染。鳞状上皮细胞的存在表明存在口咽污染。选择了一种简单的稀释技术来比较直接培养物和痰液稀释液（每毫升原始痰液10(-7)）中潜在病原体的分离情况。稀释技术使痰液培养物的读数更容易，并避免了直接检查时经常发现的肠杆菌和铜绿假单胞菌可能的过度报告。肠杆菌和铜绿假单胞菌更有可能从被鳞状上皮细胞中度或重度污染的痰液中分离出来。本文描述了使用对流免疫电泳（CIE）和协同凝集试验检测痰液中肺炎球菌抗原的方法。痰液中抗原的存在是比阳性培养更可靠的下呼吸道感染指标。协同凝集试验比CIE操作更简单，使用的昂贵抗血清量更少。
