Gram – Sputum: >25/lpf (4+) neutrophils, 0-2/lpf (1+) epithelial cells– >50/oif (4+) gram negative coccobacilli + 11-50/oif (3+) gram negative diplococci – Sample suitable for culture – Shipped May 14, 2018


A simulated sputum sample collected from a 69 year old with cough was sent to category A, C, and C1 laboratories.
Participants were expected to report the presence of neutrophils, few epithelial cells, gram negative coccobacilli and gram negative diplococci; participants were to indicate whether the sample was suitable for culture.


  1. Care should always be taken when performing a Gram stain as improper technique can result in poorly stained slides thus improper interpretation of the slide, testing, and correlation with the culture results are likely to follow.
  2. Sputa screening processes vary based on squamous epithelial cells (SEC) or neutrophils and epithelial cells in the presence of mucus.


Full critique (PDF)

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