Sputum sample storage?

Small person is *finally* being seen by the RBH for the first time tomorrow (after a huge amount of faff and stress), but I now have a new ‘dilemma’: after several weeks of struggling on with an untreated infection, her sputum is absolutely vile, but she’s mostly clearing the really good, occasionally blood-streaked stuff with physio as opposed to spontaneously throughout the day, and her appointment isn’t until 3:15. What’s the consensus view on storing sputum samples for culture? If you do do it, do you chill or not chill? We’d be leaving home at around midday, so it would still be at room temp for up to 3 hours or so before being handed over...I should have phoned and asked, but in amongst all the other stuff going on, it just didn’t cross my tiny mind 🤦‍♂️

[cofdrop-UK]

Difficult one Charlie. Ask different medics and nurses and you will get different answers eg: one nurse asked me to send one through the post!!! No way. Some say you can store it in the fridge! I usually work on 3 hours from coughing up to the petri dish (not that I have control at their end).

I asked for clarification on this from Prof. Chalmers and he emailed that sputum starts to deteriorate once it leaves the body. I do believe input from a microbiologist on this very subject would have been very helpful had it been included in the Patient Priority Bronciectasis.

I would respectfully suggest (because I know you are pretty much an expert with regard to your little ones cf) that you leave the sample until the last minute, during physio to get it from different areas of the lungs - you could put it in a cool bag. I do think though that your little one will have the opportunity during your consultation to do a sampe (probably during spirometry). You will already have your own as backup.

Not surprised it didn’t cross your mind. You have so much to do and think about.

I hope little one’s consultation goes well and her treatment improves leaps and bounds.

Please let us know how you both get on.

Love cx

[Hidden in reply to cofdrop-UK]

I know, hence seeking the ‘consensus’ view! It’s never been a concern previously, as I had the ability to go literally a mile up the road and drop a sample in whenever I saw a need. Even with tertiary, clinics were in the morning so we were usually able to get something en route by saving some of her physio for in the car. It’s on my list of questions tomorrow to see if we could utilise the gp or local hospital for opportunistic samples going forward, but that won’t change the fact that clinics are always going to be afternoons. She’ll definitely clear something fresh by the time we get there, but with cultures being so hit and miss (culture from BAL six weeks ago was completely negative of everything, but induced sputum the day before and spontaneous sputum the morning of were both properly green and positive for the (potentially) MDR pseudo 🤔🤦‍♂️), in an ideal world, I want the really horrible stuff going to the lab. Alas, though, as we all know, the world is far from ideal - I may have to suck it up this time and just hope that any sample she provides cultures the blasted bug regardless. I’m not sure what they’re going to do with her tomorrow, if anything at all given the circumstances, but she will absolutely be going in at some point in the near future, so they’ll have all the properly nasty stuff they could ask for then 🤷‍♂️

I’ve heard before of being asked to send sputum by post - I was gobsmacked the first time and it continues to absolutely astound me every time someone says they were asked to!!

Haven’t forgotten your pm, lovely lady. I’ll fill you in on all the proper, genuinely mind boggling details of the last few weeks soon. x

[Hidden in reply to cofdrop-UK]

I have sent lots of samples to our lab through the post over the years. Never a problem. These bugs like warmth. If only it was so easy to kill em off.

[cofdrop-UK in reply to Hidden]

They like warmth inside or outside the body? I don’t think it is fair on postal workers in case of breakages and personally I would not want to rely on this method, although I am glad it has worked well for you.

Cx

[Hidden in reply to cofdrop-UK]

A case of needs must sometimes. My lot have never been worried about it 'going off'. One of the drug studies we did we had to collect it in big pits for 2 weeks at a time - yes yuck. They were still able to test it. Mind you, our chief lab tecnitian was amazing. Sadly just left us for a high status job after nearly 30 years..

[Hidden in reply to cofdrop-UK]

Pots -lol pits is going it a bit!

[Gladwyn in reply to Hidden]

My mind was boggling lol at pits!!!!! 😋😋

[2greys]

I hope this helps:

pathology.leedsth.nhs.uk/pa...

[Hidden in reply to 2greys]

Thanks, 2greys. Looks like initial refrigeration and then transport in a cool bag is probably the way to go if I want to make sure they have the proper nasty stuff 👍

[CDPO16]

I think it may be best to store the sample in the fridge. As far as I know, this is OK for up to 24 hours prior to it being processed. I hope this helps and that all goes well at your appointment.

[Hidden in reply to CDPO16]

Thanks for the reply and the best wishes - literally all they have to do for the appointment to go well is listen and take the situation seriously. You wouldn’t think listening would be so hard, but an inability to listen is a big part of what’s made me move us 250 miles in the first place 👀

[sassy59]

I’ve no idea Charlie but want to wish you both well and sending love and good wishes. Xxxx

[Hidden in reply to sassy59]

Thank you, Sassy x

[Izb1]

I think keeping in a cool bag sounds sensible and hopefully it will show up the bug that your little one is suffering with. Hope your appointment goes well x

[Hidden]

You could take an empty pot with you and then she could cough some into it in the loo at the hospital. As my hospital is some way from home my sample done at home sits in my handbag for anything up to 4 hrs and they have always found what they want. These bugs tend to breed rather than die.

[Hidden]

A lot of the problems with samples not showing anything are actually down to lab procedures. Cultures get contaminated and many labs only look for a prescribed number of bacteria so miss some. Akso many take a long time to grow and so tests come back too soon as negative. Keep at them. You are doing a great job.

[GintyFerguson]

I have been told 24 hours in fridge ok but prefer on the day of course. Good luck.

[Hidden]

I was told to either drop it off at the GP or hospital. The GP requested it before 11am so it went in that days samples to the labs. The GP also advised if produced whilst with the GP or dropped in later they put it in the fridge overnight only and it goes with the next days samples. They are not particularly worrying about the length of time from being produced and its storage.