Association Between Sputum Quality and Bacterial Culture Results in Patients with Pneumonia at Klungkung General Hospital

Abstract

Pneumonia is a lower respiratory tract infection that remains one of the leading causes of morbidity and mortality worldwide, including in Indonesia. Sputum culture examination plays an important role in identifying the bacterial pathogens causing pneumonia; however, its success is highly influenced by sputum quality. This study aimed to determine the association between sputum quality and bacterial culture results in patients with pneumonia. This research was an analytical observational study with a cross-sectional design at Klungkung General Hospital, involving 53 spontaneous sputum specimens obtained using the Consecutive Sampling method. Sputum quality was assessed based on Bartlett’s criteria through gram staining, while culture examination was performed on MacConkey Agar and Blood Agar media, and identification of pathogenic bacteria was performed using the VITEK 2 Compact system. The results showed that most sputum samples from pneumonia patients had good quality (54.7%) and yielded positive bacterial cultures (72.4%), predominantly Klebsiella pneumoniae (43,4%). The Chi-square (χ²) test demonstrated a significant relationship between sputum quality and bacterial culture results (p = 0.023; PR = 4,4; 95% CI: 1,371–13,959). Good quality sputum was 4,4 times more likely to produce pathogenic bacterial growth compared to poor quality sputum. In conclusion, there is a significant association between sputum quality and bacterial culture results in patients with pneumonia at Klungkung General Hospital.