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|Title:||Usefulness of sputum gram stain for etiologic diagnosis in community-acquired pneumonia: a systematic review and meta-analysis|
|Author:||Rio Pertuz, Gaspar del|
Gutierrez, Juan F.
Triana, Abel J.
Molinares, Jorge L.
Robledo Solano, Andrea B.
Meza, Jose L.
Ariza Bolivar, Orlando M.
Acosta Reyes, Jorge
|Keywords:||Pneumònia adquirida a la comunitat|
|Abstract:||Background: implementation of sputum Gram stain in the initial assessment of community-acquired pneumonia (CAP) patients is still controversial. We performed a systematic review and meta-analysis to investigate the usefulness of sputum Gram stain for defining the etiologic diagnosis of CAP in adult patients. Methods: we systematically searched the Medline, Embase, Science Direct, Scopus and LILACS databases for full-text articles. Relevant studies were reviewed by at least three investigators who extracted the data, pooled them using a random effects model, and carried out quality assessment. For each bacterium (Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, and Gram-negative bacilli), pooled sensitivity, specificity, positive and negative likelihood ratios were reported. Results: after a review of 3539 abstracts, 20 articles were included in the present meta-analysis. The studies included yielded 5619 patients with CAP. Pooled sensitivity and pooled specificity of sputum Gram stain were 0.59 (95% CI, 0.56-0.62) and 0.87 (95% CI, 0.86-0.89) respectively for S. pneumoniae, 0.78 (95% CI, 0.72-0.84) and 0.96 (95% CI, 0.94-0.97) for H. influenzae, 0.72 (95% CI, 0.53-0.87) and 0.97 (95% CI, 0.95-0.99) for S. aureus, and 0.64 (95% CI, 0.49-0.77) and 0.99 (95% CI, 0.97-0.99) for Gram-negative bacilli. Conclusion: Sputum Gram stain test is sensitive and highly specific for identifying the main causative pathogens in adult patients with CAP.|
|Note:||Reproducció del document publicat a: https://doi.org/10.1186/s12879-019-4048-6|
|It is part of:||BMC Infectious Diseases, 2019, vol. 19, num. 1, p. 403|
|Appears in Collections:||Articles publicats en revistes (Ciències Clíniques)|
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
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