SPUTUM GRAM STAIN ASSESSMENT IN COMMUNITY-ACQUIRED BACTEREMIC PNEUMONIA
SPUTUM GRAM STAIN ASSESSMENT IN COMMUNITY-ACQUIRED BACTEREMIC PNEUMONIA
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DOI：
10.1128/jcm.26.5.846-849.1988
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发表时间：
1988-05-01
影响因子：
9.4
通讯作者：
MARTIN, R
中科院分区：
文献类型：
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作者：
GLECKMAN, R;DEVITA, J;MARTIN, R
进行了一项为期4.5年的前瞻性研究，以确定痰革兰氏染色预测社区获得性细菌性肺炎病因的能力。血培养分离株，而不是痰培养，作为参考标准，以提供病原体的精确鉴定。研究人群包括59名菌血症成人，他们咳出了有效的痰液样本。所提供的数据表明，医生在染色痰液形态学的帮助下，理论上可以在约94%的时间内选择适当的单药治疗，此时符合有效痰液微生物学的选择性定义标准。然而，五名流感嗜血杆菌引起的肺炎患者中有三名的痰染色表明有其他病原体。这项研究再次证实，革兰氏染色痰是一个可靠的，但不是绝对可靠的，指导直接初始抗生素治疗的成人社区获得性细菌性肺炎。
A prospective study was performed over a 4.5-year period to determine the ability of a sputum Gram stain to predict the cause of community-acquired bacterial pneumonia. A blood culture isolate, rather than a sputum culture, served as the reference standard to provide precise identification of the etiologic agent. The study population comprised 59 bacteremic adults who expectorated a valid sputum sample. Data are presented that indicate that a physician, aided by the morphology of the stained sputum, could theoretically select appropriate monotherapy approximately 94% of the time when selective, defined criteria for the microbiology of valid sputum are met. Three of the five patients with pneumonia caused by Haemophilus influenzae, however, had sputum stains that suggested alternative pathogens. This study reaffirms that the Gram-stained sputum is a reliable, but not infallible, guide to direct initial antibiotic therapy in adults with community-acquired bacterial pneumonia.