Rio Pertuz, Gaspar delGutierrez, Juan F.Triana, Abel J.Molinares, Jorge L.Robledo Solano, Andrea B.Meza, Jose L.Ariza Bolivar, Orlando M.Acosta Reyes, JorgeGaravito, ArgenisViasus, DiegoCarratalà, Jordi2020-10-272020-10-272019-05-101471-2334https://hdl.handle.net/2445/171566Background: 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.12 p.application/pdfengcc-by (c) Rio-Pertuz, Gaspar del et al., 2019http://creativecommons.org/licenses/by/3.0/esPneumònia adquirida a la comunitatMetaanàlisiEsputCommunity-acquired pneumoniaMeta-analysisSputuminfo:eu-repo/semantics/article6947652020-10-27info:eu-repo/semantics/openAccess31077143