Abstract

IntroductionLower respiratory tract secretions (LRTS) like sputum and tracheal aspirates are frequently sent to the microbiology laboratory from patients with various respiratory pathologies. Improper collection techniques can lead to false-positive results, resulting in improper therapy.Aim of the studyTo determine the percentage of contaminated samples sent to the microbiology laboratory, to establish the prevalence of Candida spp. in non-contaminated samples and therefore, the presence of Candida spp. originating in lower respiratory tract infections. Material andMethodsA 10-year data survey was conducted to assess the differences in Candida prevalence from contaminated versus non-contaminated samples, assessed and categorised by Bartlett grading system, and to emphasise the importance of quality control for potentially contaminated samples. The data were analysed according to gender, age, referring departments, and the species of Candida. For the statistical analysis, Kruskal-Wallis and Fisher tests were used, and the alpha value was set for 0.5.ResultsThe prevalence of Candida spp. in all analysed samples was 31.60%. After excluding the contaminated samples, the actual prevalence was 27.66%. Of all sputum samples, 31.6% were contaminated. Patients aged more than 40 years old were more prone to provide contaminated sputum samples. C. albicans is more prevalent in non-contaminated sputum samples. In both sputum and tracheal aspirates, the chances of identifying a single species are higher than the chances of identifying multiple species.ConclusionsThe study emphasises the importance of assessing the quality of sputum samples because of the high number of improperly collected samples sent to the microbiology laboratory.

Highlights

  • Lower respiratory tract secretions (LRTS) like sputum and tracheal aspirates are frequently sent to the microbiology laboratory from patients with various respiratory pathologies

  • From the complete data base of reports of the Microbiology Laboratory, Mures Clinical County Hospital, between Jan 1, 2009, to 31th of December 2018, all reports on respiratory tract samples, sent to and processed in the microbiology laboratory were scrutinised for Candida spp. growth

  • The percentage of contaminated sputum samples testing positive for Candida spp. was 31.60% (164 out of 519 analysed sputum samples)

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Summary

Introduction

Lower respiratory tract secretions (LRTS) like sputum and tracheal aspirates are frequently sent to the microbiology laboratory from patients with various respiratory pathologies. Aim of the study: To determine the percentage of contaminated samples sent to the microbiology laboratory, to establish the prevalence of Candida spp. in non-contaminated samples and the presence of Candida spp. originating in lower respiratory tract infections. C. albicans is more prevalent in non-contaminated sputum samples In both sputum and tracheal aspirates, the chances of identifying a single species are higher than the chances of identifying multiple species. Conclusions: The study emphasises the importance of assessing the quality of sputum samples because of the high number of improperly collected samples sent to the microbiology laboratory. Collecting lower respiratory tract secretions (LRTS) for the microbiological examination is a widely used diagnostic tool that can help identify Candida spp. The case fatality ratio of invasive infections in ICU is 45.9%, making Candida spp. infections a significant health problem [1]

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