Sputum examination is a simple and rapid diagnostic tool for the presumptive identification of pathogens. It is one of the oldest and most entrenched technique still in use.Identification of fastidious organisms is important in diagnosis of infections which causes serious diseases whose detection and monitoring is crucial in treating many cases. Direct gram staining places a very important role in identifying these fastidious organisms like Streptococcus pneumoniae, Haemophilus influenzae, Legionellae which may not grow in routine bacterial cultures. Correlation between direct gram staining and sputum cultures helps us to identify these fastidious organism which is crucial for initiation of treatment. This is a descriptive study conducted in the bronchitis patients admitted in the medical ward of GMKMCH, Salem for 3 month period from August, 2022 to November, 2022. 216 sputum samples collected and direct smear and bacterial culture done for the detection of fastidious organisms. 216 sputum samples were collected and direct smear by gram staining done. By bartletts scoring 182 samples were included. Out of 182 samples76 stained smear showed Gram positive cocci in 23 smears and Gram negative bacilli in 49 smears. Out of 123 plated samples, GPC isolated was 21,GNB isolated was 90 and Candida spp was 12. Only 3 Streptococccus pneumoniae were isolated. In the present study, good quality sputum samples was obtained in 182 (85%) of 216 patients, which is a higher yield than reported in previous studies. An additional benefit of sputum Gram stain is that it can validate the subsequent sputum culture results. The growth of an organism from a sputum sample does not always indicate the presence of infection. Results of sputum culture can yield false positive findings related to colonization or contamination, and thus should be utilized with the results of the sputum Gram stain when establishing the definitive etiologic diagnosis of pneumonia. Vancomycin is the highest sensitive drug with 100% sensitivity.33% of the isolates are sensitive to penicillin and 66% are resistant. sensitivity to Tetracyclines are 33% and only 33% of the isolates are sensitive to Erythromycin.66% of the isolates are sensitive for Oflxacin and least sensitivity is observed for Cotrimoxazole.

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