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

Fig1
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.
Fig2
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).

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