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 DENOMINATION
- Cultivation of bronchial secretion,
- Baciloscopia,
- Antibiograma.
DEFINITION
A cultivation, in medicine, is simply a sowing of the sputum of a patient in a suitable way that is known commonly as "a culture medium" to see if some microorganism grows. As the number of gérmenes that exists in a sample in fresh air extracted from the organism, in case of they are, is scarce, he does that it is difficult to see them in the microscope. That's why, what is done is to put the sample in a suitable environment, with sufficient nutrients so that the gérmenes could grow to good temperature, and it is left incubating a variable time. Later, one proceeds to the reading in the microscope. Normally, if there is gérmenes they usually and give grow a positive result; nevertheless, sometimes although they exist gérmenes, the result is negative. This is due to the fact that some of them are extremely sensitive and die as soon as they go out of the organism, therefore for when one proceeds to the sowing in laboratory it is already late and does not grow at all. In other occasions, the result takes a long time in an important way. This happens because all the microbes do not grow with the same speed, by what, as a certain number of them is needed so that the positive is detected, they can be needed sometimes up to several weeks to obtain a result. Nevertheless, the habitual thing is that it is obtained in less than fifteen days, normally in one week. The culture medium is not only. Different several exist according to the group of gérmenes about which we speak. The sputum cultivation consists of sowing in one or several his cultivation means, according to the germ that is suspected. With him, what is claimed is to identify the causative infections microorganisms in the low airlines: trachea, bronchi and lung.
WHY DOES IT SERVE?
To be able to confirm, in case there should be doubts, the infection diagnosis, on the one hand. For other, to know of what germ it talks each other, and what the antibiotic most indicated for his treatment is. This is important especially when the infection has not answered to the initially ruled treatment, or it is turning into an excessively long process, or if it is a question of patients whose immunity, for diverse reasons, is in this moment awkward.
HOW IS THE SAMPLE OBTAINED
For expectoration. It must be eliminated by the proper patient by means of the cough, and collection in a sterile receptacle that is given them to that end. That's why, the collaboration of the interested party is essential to obtain a sample that is of good quality, since one needs a good sample to be able to do a good diagnosis. The sputum must have more than 25 leukocytes, and less than 10 cells epiteliales for field (I increase X 100) to be adapted to study, so if it is not like that, it is that it is contaminated by oral secretions. Preferably, the capture of the sample is done by the patient on an empty stomach, of preference in the morning without the patient having taken water. One asks him to expectorate the deepest thing that could. If the patient cannot expectorate and is indispensable to take the sample of low respiratory secretions there exist diverse skills directed to favor the securing of the sputum, someone by means of the induction of the cough and others, more aggressive, that are technical to come with set of instruments up to the lung and to obtain there the necessary sample (bronchial wash, induction of sputum by means of inhalation of hypertonic whey, aspiration by means of transtorácica needle, aspiration transtraqueal (surer than the first option, but less valuable) or lung biopsy).
WHAT IS DONE BY THE SPUTUM?
Once the sample is obtained, and according to the germ that is suspected, there is a series of ways that can follow:
- To analyze a sputum smear, or, a small sample to the microscope.
- To do a special, so called coloring "of Gram", to realize an initial distinction of the germ, since in general they are or "positives to the Gram" or "negatives to the Gram", which supposes a valuable information about the most suitable antibiotics in the beginning.
- To do a so called coloring "acidic resistant alcohol", special to detect micobacterias and more specifically the bacillus of Koch, causer of the tuberculosis.
And the rest of the sample is sowed for his cultivation, with which after certain time it becomes possible to play in tune more and to go so far as to know not the group, but the concrete germ of which it is a question. The growth in the cultivation is observed every 24 hours, and only if after six weeks it has not grown nothing one is considered that it is negative and that in the sputum there was not gérmenes. This means that a patient can go so far as to be up to six weeks without a definitive result, without this being abnormal. When some pathogenic germ grows, one proceeds to a third test: the antibiograma.
THE ANTIBIOGRAMA
It consists of exhibiting the gérmenes to diverse antibiotics, and seeing which kill it, which do that it grows slower, and which do not do effect to him; this way, it is known if the treatment that the patient already has is the most appropriate, and in case of it without being, is known also which would be better that the one that goes.
WHAT DOCTOR CAN TREAT ME?
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DENOMINATION 
