GARCIA E, MARCOS M, ROUX A, PUIG J, MENSA J, MARTINEZ J, ORTEGA M, TORRES A; Interscience Conference on Antimicrobial Agents and Chemotherapy (42nd : 2002 : San Diego, Calif.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2002 Sep 27-30; 42: abstract no. L-984.

Hosp. Clinic, Barcelona, Spain.

BACKGROUND: usefulness of Sp in the approach to patients with CAP is controversial and it has not been analysed in relation to severity. The aim of this study is to evaluate its usefulness in guiding etiologic diagnosis of CAP and to assess it according to PORT score. METHODS: a cohort of 1669 patients with CAP was studied with a standard protocol. Severity of CAP was assessed using PORT-score. Sp was collected before administering antibiotic therapy at the emergency Dept. and its quality evaluated (presence of squamous epithelial and polymorphonuclear cells). Good quality samples were Gram stain and assessed for a predominant morphotype. Sputum cultures were processed according to standard protocols. RESULTS: 1669 patients were evaluated. Sp was obtained in 983 cases (59%), being of good quality in 532 (54%). A predominant morphotype was shown in 240 (45%; 14.4% out of 1669). Culture of these Sp was positive in 207 (86,2%; 157 S. pneumoniae). Rates of Sp obtained, good quality Sp, predominant morphotype identification and positive culture were not significantly different among PORT groups (p>0.05). Sensitivity, specificity, positive predictive value and negative predictive value of Gram-positive diplococci (GPD) identification for culture of S. pneumoniae in sputum were 60%, 97.6%, 91% and 85.3% respectively. 133 patients had bacteremic pneumococcal CAP; Sp was obtained in 77 (58%), of which 39 were of good quality (50.6%), 14 (36%; 10.5% out of 133) showed GPD and S. pneumoniae was isolated in 13. CONCLUSIONS: A good-quality Sp with a predominant morphotype could only be obtained in 14.4% of the patients. A PORT-score group in which Sp could be of greater usefulness in guiding etiologic diagnosis could not be identified. Gram stain was highly specific for culture of S. pneumoniae in Sp but even in patients with bacteremia, Sp provide the diagnosis in only 10.5%. Sp Gram stain was useful in guiding etiologic diagnosis of CAP in only 14.4% out of 1669 patients.

Publication Types:

• Meeting Abstracts

Keywords:

• Bacteriological Techniques
• Gentian Violet
• Gram's stain
• Humans
• Phenazines
• Pneumonia
• Sensitivity and Specificity
• Sjogren's Syndrome
• Sputum
• Staining and Labeling
• Streptococcus pneumoniae

Other ID:

• GWAIDS0027185

UI: 102266809

From Meeting Abstracts