Sputum specimens can be obtained from patients with community-acquired pneumonia in primary care

Abstract

Objective - To improve the aetiological diagnosis in community-acquired pneumonia (CAP) increased efforts were made to obtain expectorated sputum specimens from patients with CAP. Design - A prospective, clinical study. Patients were encouraged to cough spontaneously and to expectorate a sputum specimen. If unsuccessful, they were asked to inhale nebulized hypertonic saline to induce secretion and cough. Setting - One primary health care centre in Örebro, Sweden. Subjects - Patients attending the Health Centre with acute symptoms of CAP. Main outcome measures - Availability and quality of sputum specimen from patients with CAP in primary care. Results - 177 patients were included, 63% were women and the mean age was 51years. 28% were smokers and 46% showed infiltrates on chest X-ray. Sputum specimens were obtained from 125 patients. Fifty-nine were expectorated spontaneously and 66 were induced. Ninety-one of the specimens were found to be acceptable, whereas 34 were discarded. Potential pathogens were found in 57% of the 91 specimens. Conclusion - Acceptable sputum specimens can be obtained with some effort from approximately half of the patients in primary care. Sputum culture might improve the knowledge of the bacterial aetiology of CAP in selected patients and in epidemiological studies.