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Journal of Clinical Microbiology, February 1998, p. 467-469, Vol. 36, No. 2
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Value of Examining Multiple Sputum Specimens in the Diagnosis of Pulmonary Tuberculosis

Susan M. Nelson,1 Marcia A. Deike,1 and Charles P. Cartwright1,2,*

Microbiology Department, Clinical Laboratories, Hennepin County Medical Center, Minneapolis, Minnesota 55415,1 and Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota 554552

Received 10 September 1997/Returned for modification 24 October 1997/Accepted 5 November 1997

To objectively assess the value of examining multiple sputum specimens in maximizing the sensitivity of detection of Mycobacterium tuberculosis, we retrospectively reviewed the acid-fast bacillus smear and culture results of patients diagnosed with culture-proven pulmonary tuberculosis (TB) at Hennepin County Medical Center between 1986 and 1996. Two hundred and forty six persons were diagnosed with pulmonary TB in the time period analyzed. In 93% of these cases (229 of 246) the laboratory diagnosis was made by detection of M. tuberculosis in sputum specimens; however, only 52% (120 of 229) of these patients had at least three sputum specimens submitted to the laboratory at the time of diagnosis. Of the patients from whom at least three specimens were collected, 47% (56 of 120) had at least one smear-positive specimen; the third or later specimen submitted was the first smear-positive specimen for 13% (7 of 56) of these persons but was the first culture-positive specimen for only 7% (4 of 56). Of the 64 patients with smear-negative specimens, for only 5% (3 of 64) was the third or subsequent specimen submitted the first from which M. tuberculosis was recovered. This data indicates that, in our institution, the overwhelming majority of culture-proven pulmonary TB cases are diagnosed from the first or second sputum specimen submitted to the laboratory and that only rarely is a third specimen of diagnostic value.

* Corresponding author. Mailing address: Clinical Laboratories, MC #812, Hennepin County Medical Center, 701 Park Ave., Minneapolis, MN 55415. Phone: (612) 347-3026. Fax: (612) 904-4229. E-mail: charles.cartwright{at}co.hennepin.mn.us.

Journal of Clinical Microbiology, February 1998, p. 467-469, Vol. 36, No. 2
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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