01 April 2008
Assessment of the usefulness of sputum Gram stain and culture for diagnosis of community-acquired pneumonia requiring hospitalizationNaoyuki Miyashita, Hiroki Shimizu, Kazunobu Ouchi, Kozo Kawasaki, Yasuhiro Kawai, Yasushi Obase, Yoshihiro Kobashi, Mikio Oka
Med Sci Monit 2008; 14(4): CR171-176 :: ID: 850283
Background: The usefulness of sputum Gram stain and culture in guiding microbiological diagnosis of community-acquired pneumonia (CAP) is controversial. We evaluated the role of sputum examination at a university teaching hospital.
Material/Methods: Three hundred forty-seven adult patients with CAP were enrolled in this study. Before administering antibiotic therapy, sputum was collected and its quality evaluated. Samples were gram stained and those of good quality were assessed for a predominant morphotype.
Results: Sputum samples were obtained from 216 patients (62%), and of these 124 (57%) samples were good quality and 80 (65%) showed a predominant morphotype. Sputum culture yielded a causative organism in 70 (88%) of the 80 samples with a predominant morphotype. In the cases of patients who had received previous antibiotic treatment, a good quality samples showing a predominant morphotype and positive culture was less frequently obtained from than from those who had not (p<0.0001). The sensitivity and specificity of the gram-positive diplococci identification in the sputum culture of S. pneumoniae were 68.2% and 93.8%, respectively, and the sensitivity and specificity of the gram-negative coccobacilli identification in the sputum culture of H. influenzae were 76.2% and 100%, respectively.
Conclusions: Gram stain of sputum samples was useful in guiding microbiological diagnosis of CAP in 23% of patients. The Gram stain and culture of sputum samples obtained from patients who have received antibiotic treatment was unreliable. The presence of gram-positive diplococci and gram-negative coccobacilli was highly specific for the culture of S. pneumoniae and H. influenzae, respectively.
Keywords: Hospitalization, Streptococcus pneumoniae - isolation & purification, Sputum - microbiology, Process Assessment (Health Care), Pneumonia, Pneumococcal - microbiology, Phenazines, Gentian Violet, Community-Acquired Infections - microbiology, Colony Count, Microbial, Aged, 80 and over, Adolescent
01 November 2021 : EditorialEditorial: What Can be Learned from National and International Vaccine Adverse Event Reporting Systems During the COVID-19 Pandemic?
Med Sci Monit 2022; 28:e935299
26 November 2021 : EditorialEditorial: SARS-CoV-2 Vaccine Responses and Breakthrough COVID-19
Med Sci Monit In Press; DOI: 10.12659/MSM.935624
08 November 2021 : Database AnalysisVirtual Screening and Molecular Docking to Study the Mechanism of Chinese Medicines in the Treatment of Cor...
Med Sci Monit In Press; DOI: 10.12659/MSM.934102
01 November 2021 : EditorialEditorial: What Can be Learned from National and International Vaccine Adverse Event Reporting Systems Duri...
Med Sci Monit 2022; 28:e935299
29 Nov 2021 : Database AnalysisIntegrated Analysis of Angiogenesis-Mediated Tumor Immune Microenvironment Pattern in Hepatocellular Carcin...
Med Sci Monit In Press; DOI: 10.12659/MSM.934937
26 Nov 2021 : Clinical ResearchSerum Uric Acid Levels in Relation to Atrial Fibrillation: A Case-Control Study
Med Sci Monit In Press; DOI: 10.12659/MSM.934007
26 Nov 2021 : Database AnalysisNetwork Pharmacology Integrated Molecular Docking Revealed the Mechanism of Jianpi Yiqi Taohua Decoction Ag...
Med Sci Monit In Press; DOI: 10.12659/MSM.933537
Most Viewed Current Articles
20 Mar 2020 : Clinical ResearchSocial Capital and Sleep Quality in Individuals Who Self-Isolated for 14 Days During the Coronavirus Diseas...
Med Sci Monit 2020; 26:e923921
15 Apr 2020 : Clinical ResearchPsychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 20...
Med Sci Monit 2020; 26:e924171
05 May 2020 : Review articleAn Evidence Based Perspective on mRNA-SARS-CoV-2 Vaccine Development
Med Sci Monit 2020; 26:e924700