Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Quality of sputum samples is commonly assessed, preculture, using the modified Murray and Washington's six grouping system.However, this system has limitations because epithelial cells (ECs) and white blood cells (WBCs) are each categorized into three groups, and a complete matrix should comprise nine possible groups.In this study, the aim was to establish the acceptability of the additional groups.Methods: De-identified sputum quality assessments and the corresponding culture results between 2022 and 2024 were retrospectively analyzed.All samples were categorized based on the established grouping system, and groups 7 to 9 were new additions.Subsequently, the culture-positive rates were calculated.Finally, analysis of variance and post hoc analysis were performed to compare the culture-positive rates between groups 4 to 7. Results: Sputum quality assessment was performed on 3,642 samples, of which 1,437 (39.5%) were classified into groups 4 to 7. The rates of the identified strains in groups 4, 5, and 6, were 28.8%, 31.7%, and 18.4%, respectively.Group 7, which was defined as having <10 ECs and 10 to 25 WBCs per low-power field, had a rate of identified strains of 22.9%.There was no significant difference between the rate of identified strains of group 7 and those of groups 4 and 6 (P=0.373 and P=0.753, respectively).Conclusions: The results revealed that group 7 is an acceptable sputum quality group because it is not significantly different to multiple acceptable sputum groups.Further studies are required to determine the acceptability of all nine possible sputum groups.
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Award: G1120264153
OpenAlex ID: W7140098029
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