# Analysis of Sequential Aliquots of Hypertonic Saline Solution-Induced Sputum: Urea

Urea was detected in all subjects and in all samples. The mean urea concentration was 4 ± 1 mg/dL, 3 ± 1 mg/dL, 3 ± 1 mg/dL, 4 ± 1 mg/dL, and 3 ± 1 mg/dL at the five time points. The mean change from the 0- to 4-min sample to the 16- to 20-min sample was 0.20 mg/dL (95% CI, — 0.65 to 0.25). There was no linear trend in urea concentration with time (p = 0.99).

**Total Cell Counts and Cell Differentials**

The total cell counts of samples collected at 4, 8, 12, 16, and 20 min (mean ± SEM) were 1.8 ± 1.6 X 107/mL, 1.8 ± 1.8 X 107/mL, 1.8 ± 1.7 X 107/ mL, 1.6 ± 1.7 X 107/mL, and 1.8 ± 1.8 X 107/mL, respectively (Fig 1). The mean change was 0.016 log10 cells per milliliter (95% CI, — 0.193 to 0.225). The nonsquamous cell counts per sample were 1.8 ± 1.7 X 107/mL, 1.7 ± 1.8 X 107/mL, 1.8 ± 1.7 X 107/mL, 1.6 ± 1.7 X 107/mL, and 1.9 ± 1.8 X 107/ mL, respectively. There was no sample at the 20-min time point in one patient. There was no difference in nonsquamous cell count over time (p = 0.99). The percentage of squamous cells were 5.9 ± 6.6%, 6.8 ± 10.1%, 4.7 ± 5.2%, 5.1 ± 4.7%, and 3.4 ± 2.6% for each time point (p = 0.83). The percentage of neutrophils (mean ± SD) were 89 ± 5%, 88 ± 4%, 87 ± 4%, 84 ± 6%, and 86 ± 4%, sequentially (Fig 1), thus slightly decreasing over time (p = 0.03). The percentage macrophage count was 5 ± 2%, 7 ± 3%, 7 ± 3%, 10 ± 5%, and 8 ± 4%, thus mildly increasing over time (p < 0.01; Fig 1).

**Microbiology**

The number of organisms in study subjects ranged from two to seven. In addition to the presence, the quantitation of a specific set of organisms was examined. Mucoid and nonmucoid Pseudomonas aeruginosa (mucoid n = 9, nonmucoid n = 5), Staphylococcus aureus (n = 6), Burkholderia cepacia (n = 1), Stenotrophomonas maltophilia (n = 4), Achro-mobacter (formerly Alcaligenes) xylosoxidans (n = 2), Haemophilus influenzae (n = 0), Enteroco-cus (n = 1), Acinobacter (n = 1) and Ralstonia pick-ettii (n = 6) were selected. Quantitation of each organisms in each sample was also examined (Fig 2). canadian good neighbor pharmacy

*Figure 1. The total number of cells and the differential WBC count from induced-sputum aliquots. The total number of cells from the induced-sputum aliquots remained constant over time (p = 0.99). The percentage of PMNs decreased slightly and the percentage alveolar macrophages increased slightly over time (p = 0.03 and p < 0.01, respectively).Macs = alveolar macrophages.
Figure 2. The microbiological counts from induced-sputum aliquots. Nine subjects had mucoid P aeruginosa, five subjects had nonmucoid P aeruginosa, and six subjects had S aureus. The bacteriological counts of nonmucoid P aeruginosa and S aureus changed over time (p = 0.05 and p < 0.01, respectively).*