It is important to regularly test your sputum so that you and your PCD team can be aware of what might be growing in your lungs. Sending in a sputum sample approximately four times a year is a useful way of monitoring this and will help you manage your condition in the short and long term. You can send a sputum sample via your GP or PCD centre. It is advisable to keep a note of any bacteria you grow and to share this with your GP or PCD centre for their records. Sending off regular sputum samples will make sure you are on the right type of antibiotics (both for prophylaxis and rescue antibiotics), as not all bacteria respond to certain types of antibiotic.
You should also send a sputum sample for testing every time you think you have a chest infection. Often when you have an infection, you will feel unwell and your sputum may change colour, but this is not always the case. Some common signs of becoming unwell with a chest infection include sputum colour change, producing more sputum, noticing a change in taste or smell to your sputum, chest pain, shortness of breath, temperatures, feeling more tired than usual, joint aches. There may be other symptoms too. You will get to know these symptoms over time.
You can expect your sputum results to take about one week from the point of sending off the test. Normally you will call up your GP (or hospital – if that is who sent it off) for these results, and sometimes they will contact you. Some people with PCD regularly grow bacteria (often called ‘bugs’) in their lungs, without feeling unwell. If this happens, your PCD team will work with you to decide whether to treat this or not. If you are feeling unwell, your GP or hospital will normally recommend two weeks of antibiotics, commonly referred to as ‘rescue antibiotics’. If you are still feeling unwell these two weeks of antibiotics, you should speak to your doctor about whether to send off another sputum sample to see if the infection is still there.
Some bacteria that are commonly present in the natural environment can be harmful to those with PCD and it is important to make sure that you regularly get your sputum checked for this. The bronchiectasis guidelines recommend that you ask your GP to check your sputum under cystic fibrosis protocol. This means they will check for bacteria that don’t usually cause problems in healthy lungs but can cause infections in PCD.
Most GPs will put some pots and forms together for you to take home, so that if you decide you need to test your sputum, you can drop in a sample without needing to arrange a doctor’s appointment. Most doctors recommend your sputum sample being the first cough of the morning (as this is more likely to have bacteria in it). You should drop off your sample the same day that you do it. Some people find it helpful to ask their doctor’s surgery what time the sputum sample collections are, so that they can ensure their test is collected the same day.
Many patients keep a note of the bacteria that they grow in their sputum samples. This can be helpful to know, particularly if you regularly see different doctors. The most common bacteria grown in people with PCD are staphylococcus aureus, streptococcus pneumoniae and haemophilus influenzae, however this varies from person to person. There are an increasing number of patients growing a bug called pseudomonas aeruginosa, which can be difficult to treat. Take a look at a previous talk we had about this, here.