Tags

Type your tag names separated by a space and hit enter

Assessment of the usefulness of sputum culture for diagnosis of community-acquired pneumonia using the PORT predictive scoring system.
Arch Intern Med. 2004 Sep 13; 164(16):1807-11.AI

Abstract

BACKGROUND

The usefulness of sputum culture in guiding microbiological diagnosis of community-acquired pneumonia is controversial. We evaluate and assess it using the Patients Outcome Research Team (PORT) predictive scoring system.

METHODS

A cohort of 1669 patients with community-acquired pneumonia was studied. 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 (PM). Sputum cultures were processed according to standard protocols.

RESULTS

A sputum sample was obtained from 983 (59%) of the 1669 patients and 532 (54%) of the samples were of good quality. There was a PM in 240 (45%) of the latter samples (ie, for 14.4% of the 1669 patients) and there was no PM in 292 (55%). Culture yielded a microorganism in 207 (86%) of the 240 samples with PM and 57 (19.5%) of the 292 samples without PM (P<.05). Rates of sputum obtained, good-quality sputum specimens, PM identification, and positive culture were not significantly different among the PORT-score groups of patients (P>.05). The sensitivity and specificity of the gram-positive diplococci identification in the sputum culture of Streptococcus pneumoniae were 60% and 97.6%, and the positive and negative predictive values were 91% and 85.3%, respectively.

CONCLUSIONS

Good-quality sputum with PM could be obtained in only 14.4% of all patients. A PORT-score group in which sputum could be of greater usefulness in identifying the causative organism could not be identified. The presence of gram-positive diplococci in gram-stained sputum culture was highly specific for S pneumoniae.

Authors+Show Affiliations

Department of Infectious Diseases, Hospital Clínic, Barcelona, Spain. elisag@eresmas.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15364677

Citation

García-Vázquez, Elisa, et al. "Assessment of the Usefulness of Sputum Culture for Diagnosis of Community-acquired Pneumonia Using the PORT Predictive Scoring System." Archives of Internal Medicine, vol. 164, no. 16, 2004, pp. 1807-11.
García-Vázquez E, Marcos MA, Mensa J, et al. Assessment of the usefulness of sputum culture for diagnosis of community-acquired pneumonia using the PORT predictive scoring system. Arch Intern Med. 2004;164(16):1807-11.
García-Vázquez, E., Marcos, M. A., Mensa, J., de Roux, A., Puig, J., Font, C., Francisco, G., & Torres, A. (2004). Assessment of the usefulness of sputum culture for diagnosis of community-acquired pneumonia using the PORT predictive scoring system. Archives of Internal Medicine, 164(16), 1807-11.
García-Vázquez E, et al. Assessment of the Usefulness of Sputum Culture for Diagnosis of Community-acquired Pneumonia Using the PORT Predictive Scoring System. Arch Intern Med. 2004 Sep 13;164(16):1807-11. PubMed PMID: 15364677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of the usefulness of sputum culture for diagnosis of community-acquired pneumonia using the PORT predictive scoring system. AU - García-Vázquez,Elisa, AU - Marcos,María Angeles, AU - Mensa,José, AU - de Roux,Andrés, AU - Puig,Jordi, AU - Font,Carmen, AU - Francisco,Gloria, AU - Torres,Antonio, PY - 2004/9/15/pubmed PY - 2005/2/16/medline PY - 2004/9/15/entrez SP - 1807 EP - 11 JF - Archives of internal medicine JO - Arch Intern Med VL - 164 IS - 16 N2 - BACKGROUND: The usefulness of sputum culture in guiding microbiological diagnosis of community-acquired pneumonia is controversial. We evaluate and assess it using the Patients Outcome Research Team (PORT) predictive scoring system. METHODS: A cohort of 1669 patients with community-acquired pneumonia was studied. 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 (PM). Sputum cultures were processed according to standard protocols. RESULTS: A sputum sample was obtained from 983 (59%) of the 1669 patients and 532 (54%) of the samples were of good quality. There was a PM in 240 (45%) of the latter samples (ie, for 14.4% of the 1669 patients) and there was no PM in 292 (55%). Culture yielded a microorganism in 207 (86%) of the 240 samples with PM and 57 (19.5%) of the 292 samples without PM (P<.05). Rates of sputum obtained, good-quality sputum specimens, PM identification, and positive culture were not significantly different among the PORT-score groups of patients (P>.05). The sensitivity and specificity of the gram-positive diplococci identification in the sputum culture of Streptococcus pneumoniae were 60% and 97.6%, and the positive and negative predictive values were 91% and 85.3%, respectively. CONCLUSIONS: Good-quality sputum with PM could be obtained in only 14.4% of all patients. A PORT-score group in which sputum could be of greater usefulness in identifying the causative organism could not be identified. The presence of gram-positive diplococci in gram-stained sputum culture was highly specific for S pneumoniae. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/15364677/Assessment_of_the_usefulness_of_sputum_culture_for_diagnosis_of_community_acquired_pneumonia_using_the_PORT_predictive_scoring_system_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.164.16.1807 DB - PRIME DP - Unbound Medicine ER -