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Sputum should be collected for:
Collect samples 8 - 24 hours apart
Specimens should be collected in either a well-ventilated area or a sputum collection booth. Health care workers collecting the sputum, regardless of the setting, must observe the appropriate infection control precautions. Collection of early morning specimens is preferred because of the overnight accumulation of secretions; however, you may collect specimens at any time for patients who have a deep cough that is readily productive.
Collect sputum in a sterile container for processing and examination. Sputum should be collected under direct observation, at least for the first time. This is to insure that the patient is being properly coached and is giving a good coughing effort, as well as insuring that uncooperative patients are producing their own sputum for examination.
Instruct the patient to breathe deeply and cough from deep down in the lungs. Instruct them that saliva and upper respiratory secretions are not sputum and are not acceptable specimens. For patients unable to bring up sputum, deep coughing may be induced by inhalation of an aerosol of warm, hypertonic (5%-15%) saline.
Remember the following: For public health planning purposes, the degree of infectiousness is determined by the presence of AFB in the sputum, not in bronchial washings, tracheal aspirates, or other pulmonary specimens. The presence of AFB in specimens other than sputum is not particularly useful for determining how soon and to what extent a contact investigation needs to be done. Therefore, regardless of the decision to perform a bronchoscopy or other diagnostic procedure, sputum should still be collected at the time the diagnostic evaluation is performed.