SynthesisClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Sputum Gram Stain for Bacterial Pathogen Diagnosis in Community-acquired Pneumonia: A Systematic Review and Bayesian Meta-analysis of Diagnostic Accuracy and Yield.
Synthesis in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed, 80 citations in OpenAlex.
- Microbiome Profiling Reveals Prognostic Heterogeneity inmedRxiv : the preprint server for health sciences · 2026Article
- Article
- Article
- Rethinking Pneumococcal Urinary Antigen Testing in the Emergency Department: From Reflex Testing to Reasoned Use.Cureus · 2026Article
- Clinical usefulness of repeated sputum culture for the identification of pneumonia pathogens: A retrospective study.PloS one · 2026Article
- Adapting global guidelines to local contexts: optimising community-acquired pneumonia (CAP) specific prescribing in Pakistan to counter antimicrobial resistance.BMJ open respiratory research · 2025Article
- Burden of bacterial antimicrobial resistance 1990-2021 in China: a systematic analysis for the global burden of disease study 2021.BMC medicine · 2025Article
- Challenges in Diagnosing Post-COVID Pneumonia in Kazakhstan - The Role of Point-of-Care Testing: A Letter to the Editor.Iranian journal of medical sciences · 2025Article
- Impact of Respiratory Multiplex Polymerase Chain Reaction (PCR) on Antibiotic Stewardship: A Real-World Experience.Cureus · 2025Article
- Can clinical findings at admission allow withholding of antibiotics in patients hospitalized for community acquired pneumonia when a test for a respiratory virus is positive?Pneumonia (Nathan Qld.) · 2025Article
- Microbiological Etiology and Detection of Drug-Resistant Bacteria in Pneumonia in Patients with Organophosphate Poisoning in the Intensive Care Unit.Infection and drug resistance · 2025Article
- Eosinophilia Is a Favorable Marker for Pneumonia in Chronic Obstructive Pulmonary Disease.Tuberculosis and respiratory diseases · 2024Article
- Diagnosis and Therapy of Community-Acquired Pneumonia in the Emergency Department: A Retrospective Observational Study and Medical Audit.Journal of clinical medicine · 2024Article
- Determining causal pathogens and inflammatory state of mastitis in dairy cows via Gram staining of precipitates in milk.Frontiers in veterinary science · 2024Article
- Capabilities of GPT-4o and Gemini 1.5 Pro in Gram stain and bacterial shape identification.Future microbiology · 2024Article
- Diagnostic accuracy of the BioFire® FilmArray® pneumonia panel in COVID-19 patients with ventilator-associated pneumonia.BMC infectious diseases · 2023Article
- Triage body temperature and its influence on patients with acute myocardial infarction.BMC cardiovascular disorders · 2023Article
- Evaluation of the BioFireDiagnostics (Basel, Switzerland) · 2023Article
- Gram Stain and Culture of Sputum Samples Detect Only Few Pathogens in Community-Acquired Lower Respiratory Tract Infections: Secondary Analysis of a Randomized Controlled Trial.Diagnostics (Basel, Switzerland) · 2023Article
- Prepandemic viral community-acquired pneumonia: Diagnostic sensitivity and specificity of nasopharyngeal swabs and performance of clinical severity scores.Journal of medical virology · 2023Observational
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundThe clinical role of sputum Gram stain (SGS) in community-acquired pneumonia (CAP) diagnosis remains controversial. A 1996 meta-analysis of the diagnostic accuracy of SGS reported heterogeneous results. To update the available evidence, we performed a systematic review and a Bayesian standard and latent-class model meta-analysis.
methodsWe searched Medline, Embase, and Cochrane Central by 23 August 2018 to identify studies reporting on the diagnostic accuracy, yield (percentage of patients with any pathogen[s] correctly identified by SGS), and clinical outcomes of SGS in adult patients with CAP. Two reviewers extracted the data. We quantitatively synthesized the diagnostic accuracy and yield, and descriptively analyzed other outcomes.
resultsTwenty-four studies with 4533 patients were included. The methodological and reporting quality of the included studies was limited. When good-quality sputum specimens were selected, SGS had a summary sensitivity of 0.69 (95% credible interval [CrI], .56-.80) and specificity of 0.91 (CrI, .83-.96) for detecting Streptococcus pneumoniae, and a sensitivity of 0.76 (CrI, .60-.87) and specificity of 0.97 (CrI, .91-.99) for Haemophilus influenzae. Adjusted analyses accounting for imperfect reference standards provided higher-specificity estimates than the unadjusted analyses. Bacterial pathogens were identified in 73% (CrI, 26%-96%) of good-quality specimens, and 36% (CrI, 22%-53%) of all specimens regardless of quality. Evidence on other bacteria was sparse.
conclusionsSGS was highly specific to diagnose S. pneumoniae and H. influenzae infections in patients with CAP. With good-quality specimens, SGS can provide clinically actionable information for pathogen-directed antibiotic therapies.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.