The Bartlett system for grading sputum smears uses the number of leukocytes and oral epithelial cells to help separate suitable from poor specimens. This is important to minimize wasted resources from evaluating suboptimal specimens.
Parameter
Finding
Adjust
average number of neutrophils in 20-30 ten times objective (low power) field
< 10
add 0
10-25
add 1
> 25
add 2
average number of oral epithelial cells in 20-30 low power (10x objective) fields
10-25
subtract 1
> 25
subtract 2
mucus (as opposed to saliva)
present
add 1
Interpretation:
• minimum score: -2
• maximum score: +3
• A score <=0 indicates a lack of active inflammation and/or contamination with saliva. A repeat specimen should be requested.
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