title: [Usefulness of sputum Gram staining in community-acquired pneumonia].
abstract: To evaluate the usefulness of sputum gram staining in community-acquired pneumonia (CAP), we reviewed 144 cases requiring hospitalization in the last 4 years. The sensitivity was 75.5%, specificity 68.2%, positive predictive value 74.1%, negative predictive value 69.8%, positive likelihood ratio 2.37, negative likelihood ratio 0.36 and accuracy 72.2% in 97 cases. Both sputum gram staining and culture were performed. Concerning bacterial pneumonia (65 cases), we compared the Gram staining group (n = 33), which received initial antibiotic treatment, based on sputum gram staining with the Empiric group (n = 32) that received antibiotics empirically. The success rates of the initial antibiotic treatment were 87.9% vs. 78.1% (P = 0.473); mean hospitalization periods were 9.67 vs. 11.75 days (P = 0.053); and periods of intravenous therapy were 6.73 vs. 7.91 days (P = 0.044), respectively. As for initial treatment, penicillins were used in the Gram staining group more frequently (P < 0.01). We conclude that sputum gram staining is useful for the shortening of the treatment period and the appropriate selection of initial antibiotics in bacterial pneumonia. We believe, therefore, that sputum gram staining is indispensable as a diagnostic tool CAP.
authors.affiliation: Department of Pneumology, St. Luke's International Hospital, Tokyo 104-8560.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Sato
authors.forename: Masahiro
authors.initials: M
authors.lastname: Aoshima
authors.forename: Norio
authors.initials: N
authors.lastname: Ohmagari
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tada
authors.forename: Naohiko
authors.initials: N
authors.lastname: Chohnabayashi
mesh_terms: D000328:Adult; D000368:Aged; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D005840:Gentian Violet; D006801:Humans; D008297:Male; D008875:Middle Aged; D010619:Phenazines; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000382:microbiology; D012680:Sensitivity and Specificity; D013183:Sputum / Q000382:microbiology*; D013194:Staining and Labeling
chemical_list: C035863:Gram's stain; D010619:Phenazines; D005840:Gentian Violet