Pus in Sputum Associated with Disease-prone Bacteria in Bronchiectasis

Pus in Sputum Associated with Disease-prone Bacteria in Bronchiectasis

The presence of pus (purulence) in sputum samples from bronchiectasis patients is associated with an imbalance in microbial communities and a higher prevalence of potential disease-prone bacteria, a new study suggests.

The study, “Sputum purulence-associated microbial community compositions in adults with bronchiectasis” was published in the Journal of Thoracic Disease.

Sputum, which results from overproduction of mucus and intense airway inflammation, is one of the major complaints among bronchiectasis patients. Clinically, sputum purulence has been important in reflecting the intensity of inflammation and infection of the airways in these patients, and purulence is also usually associated with the presence of a pathogen.

Antibiotics are usually prescribed based on sputum purulence characteristics, the volume of mucus and the frequency of coughing.

However, antibiotics are often prescribed without a bacteria culture confirmation, which shows what bacteria are more prominent in the sputum. Nonetheless, bacteria cultures can be misleading; many disease-causing (pathogenic) bacteria are not easily cultured.

Researchers aimed to characterize how purulence correlates with the types of bacteria present in the sputum of bronchiectasis patients. To do so, they analyzed 105 sputum samples from bronchiectasis patients to compare bacterial diversity between purulent and non-purulent sputum, as well as culture-positive and culture-negative purulent sputum.

Researchers also analyzed samples collected during exacerbation episodes (48 or more hours of worsening symptoms), and compared them to samples collected from the same patients during the stable phase of the disease.

The results further confirmed a study from 2012 showing that sputum purulence was strongly associated with infections with potentially pathogenic bacteria.

The data now obtained showed that purulent sputum samples from which it was possible to culture bacteria displayed the highest degree of airway dysbiosis — alteration of the type of bacteria usually present in healthy airways. In these patients, the most prominent bacteria were Proteobacteria and/or Pseudomonas spp., which are potentially pathogenic.

These patients (with purulent culture-positive sputum) were also the group who had the least variation in bacterial diversity between the stable phase and exacerbation episodes, maintaining the same variety of bacteria. This indicates that sputum purulence and bacteria culture findings might be complementary in guiding treatment decisions.

Overall, the results suggest that bacterial “culture findings coupled with sputum purulence assessment may better guide clinicians for antibiotics prescription,” the team concluded.


  1. Kathy Atkins says:

    What hospitals specialize in treatment or a treatment plan for bronchiectasis? I only heard of the Jewish Hosiptal in Denver that does a work up and treatment plan . They have a team of doctors that specialize in bronchiectasis. I would like a work up to get a baseline of where I’m at with this disease. I live in Las Vegas NV is the Jewish Hosiptal in Denver my best closest option?
    Any help would be appreciated, thank you

  2. Ron Lawson says:

    Requirements for sputum collection are difficult to meet:
    – no saliva (I find this impossible),
    – no food
    – take to lab within 4 hours
    – sample size must be a dessert-spoon volume.
    My doctor is sympathetic – she says these are lab requirements, not hers.

    • PJ says:

      There is equipment that can cause you to cough. You sit in a box like machine and breath in a saline solution, you use it like an inhaler, this causes you to continually cough, until you get the desired amount of sputum. You would have to go to a facility that has one of these box like machines, sorry I do not know the name of it. But I have used it successfully to get diagnosed with ABPA. Good luck

  3. Victoria Greene, Los Angeles says:

    National Jewish Respiratory Health in Denver is the best. I’ve been there. I recommend that you try to have them see you. Don’t know any other place in the West, but National Jewish is considered the best in the United States for respiratory diseases.

  4. Heather Joan Harvey says:

    Recently on BBC 1 television in the UK there was a programme on antibiotics and at the end of the programme they talked to a woman who had chronic bronchiectasis and she had been in touch with a clinic called Phage Therapy Centre in Georgia (Russia)Tblisi who are trying out a new kind of treatment called Phages. I have yet to research this but the lady who took part mentioned that she was not so dependent on antibiotics since taking part in the treatment

  5. Sandra - Michigan says:

    I have been in contact with the National Jewish Health and plan to go soon to have a work up done. I hope they can provide a better plan than what I currently have.

    Also, I am curious to know if your bronchiectasis is affected in hot, cold, rainy, and/or windy weather. I find that it affects me in all weather conditions. My airways constrict and makes it difficult for me to breath. Do anyone else deal with the same thing?

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