QUANTITATIVE SPUTUM GRAM STAINS IN CHRONIC BRONCHIAL DISEASE

The assessment of bacterial flora of the bronchial system can provide useful information for determining the presence of acute bacterial infections in patients with chronic bronchial disease. The value of quantitative sputum gram stains performed in patients was examined during acute bronchial exacerbations, recovery from such exacerbations, acute allergic exacerbations of chronic extrinsic asthma and a stable period. The mean number of each morphologic type of microorganism was determined for 20 oil immersion fields. Of the patients without clinical evidence of bacterial infection, 99% had fewer than 16 Haemophilus influenzae-like, 10 pneumococcus-like and 18 Neisseria-like microorganisms/Gram stain oil immersion field. Even during the recovery period, when the patients were on antibiotics, we noted few gram-negative rods, diphtheroid-like or Staphylococcus-like microorganisms on Gram stain. Upper limits may be set for numbers of microorganisms seen on Gram stain in the absence of clinical apparent acute bacterial infection in chronic lung disease.