Diagnostic performance of the Sputum Gram Stain in predicting sputum culture results for critically ill pediatric patients with pneumonia
Background: The sputum Gram stain is an inexpensive, rapid, and convenient laboratory method that predicts the bacterial pathogens in patients with pneumonia. This study aimed to evaluate the diagnostic performance of this method in predicting sputum culture results for critically ill pediatric pati...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-08-01
|
| Series: | Pediatrics and Neonatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957220300541 |
| _version_ | 1818180297711157248 |
|---|---|
| author | Wun-Yan Huang Ming-Sheng Lee Liang-Mei Lin Yi-Chen Liu |
| author_facet | Wun-Yan Huang Ming-Sheng Lee Liang-Mei Lin Yi-Chen Liu |
| author_sort | Wun-Yan Huang |
| collection | DOAJ |
| description | Background: The sputum Gram stain is an inexpensive, rapid, and convenient laboratory method that predicts the bacterial pathogens in patients with pneumonia. This study aimed to evaluate the diagnostic performance of this method in predicting sputum culture results for critically ill pediatric patients. Methods: From June 2008 to June 2018, patients with pneumonia with an endotracheal or a tracheostomy tube in place in the Pediatric Intensive Care Unit at Changhua Christian Hospital were enrolled retrospectively. Sputum was collected from each patient via the artificial airway for Gram stain and culture evaluations of bacterial pathogens. Mixed culture results were excluded. A successful prediction was defined as a match of the sputum Gram stain and culture results. Results: A total of 622 records were reviewed, of which 542 were analyzed. Haemophilus influenzae, Pseudomonas aeruginosa, and Streptococcus pneumoniae were the three most common pathogens found. The overall prediction success rate of the sputum Gram stain was 59.23%. The sensitivity of the method in predicting gram-negative bacilli (GNB), gram-negative cocci (GNC), and gram-positive cocci (GPC) was 0.45, 0.67, and 0.61, respectively. Its specificity in predicting GNB, GNC, and GPC was 0.87, 0.98, and 0.87, respectively. Its positive likelihood ratio in predicting GNB, GNC, and GPC was 3.46, 33.50, and 4.69, respectively. The highest prediction success rate among all pathogens was for GNC. Conclusion: The sputum Gram stain had high specificity and relatively low sensitivity in predicting the bacterial pathogens in critically ill pediatric patients. Its high specificity in predicting sputum culture results means that clinicians can confidently use sputum Gram stain results to guide their antibiotic choice for treatment. |
| first_indexed | 2024-12-11T21:17:32Z |
| format | Article |
| id | doaj.art-0d6b9ac2d26d44629d55bb2f1c9f350b |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2024-12-11T21:17:32Z |
| publishDate | 2020-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj.art-0d6b9ac2d26d44629d55bb2f1c9f350b2022-12-22T00:50:33ZengElsevierPediatrics and Neonatology1875-95722020-08-01614420425Diagnostic performance of the Sputum Gram Stain in predicting sputum culture results for critically ill pediatric patients with pneumoniaWun-Yan Huang0Ming-Sheng Lee1Liang-Mei Lin2Yi-Chen Liu3Department of Pediatric Emergency Medicine, China Medical University Children's Hospital, China Medical University, Taichung, TaiwanDepartment of Pediatric Pulmonology and Critical Care, Changhua Christian Children Hospital, Changhua, Taiwan; Graduate Program in Nutrition, Chung Shan Medical University, Taichung, TaiwanRespiratory Therapy Section for Children, Changhua Christian Children Hospital, Changhua, TaiwanRespiratory Therapy Section for Children, Changhua Christian Children Hospital, Changhua, Taiwan; Corresponding author. No. 135, Nanxiao St., Changhua City, Changhua County, 500, Taiwan.Background: The sputum Gram stain is an inexpensive, rapid, and convenient laboratory method that predicts the bacterial pathogens in patients with pneumonia. This study aimed to evaluate the diagnostic performance of this method in predicting sputum culture results for critically ill pediatric patients. Methods: From June 2008 to June 2018, patients with pneumonia with an endotracheal or a tracheostomy tube in place in the Pediatric Intensive Care Unit at Changhua Christian Hospital were enrolled retrospectively. Sputum was collected from each patient via the artificial airway for Gram stain and culture evaluations of bacterial pathogens. Mixed culture results were excluded. A successful prediction was defined as a match of the sputum Gram stain and culture results. Results: A total of 622 records were reviewed, of which 542 were analyzed. Haemophilus influenzae, Pseudomonas aeruginosa, and Streptococcus pneumoniae were the three most common pathogens found. The overall prediction success rate of the sputum Gram stain was 59.23%. The sensitivity of the method in predicting gram-negative bacilli (GNB), gram-negative cocci (GNC), and gram-positive cocci (GPC) was 0.45, 0.67, and 0.61, respectively. Its specificity in predicting GNB, GNC, and GPC was 0.87, 0.98, and 0.87, respectively. Its positive likelihood ratio in predicting GNB, GNC, and GPC was 3.46, 33.50, and 4.69, respectively. The highest prediction success rate among all pathogens was for GNC. Conclusion: The sputum Gram stain had high specificity and relatively low sensitivity in predicting the bacterial pathogens in critically ill pediatric patients. Its high specificity in predicting sputum culture results means that clinicians can confidently use sputum Gram stain results to guide their antibiotic choice for treatment.http://www.sciencedirect.com/science/article/pii/S1875957220300541gram stainpediatricsputum culture |
| spellingShingle | Wun-Yan Huang Ming-Sheng Lee Liang-Mei Lin Yi-Chen Liu Diagnostic performance of the Sputum Gram Stain in predicting sputum culture results for critically ill pediatric patients with pneumonia Pediatrics and Neonatology gram stain pediatric sputum culture |
| title | Diagnostic performance of the Sputum Gram Stain in predicting sputum culture results for critically ill pediatric patients with pneumonia |
| title_full | Diagnostic performance of the Sputum Gram Stain in predicting sputum culture results for critically ill pediatric patients with pneumonia |
| title_fullStr | Diagnostic performance of the Sputum Gram Stain in predicting sputum culture results for critically ill pediatric patients with pneumonia |
| title_full_unstemmed | Diagnostic performance of the Sputum Gram Stain in predicting sputum culture results for critically ill pediatric patients with pneumonia |
| title_short | Diagnostic performance of the Sputum Gram Stain in predicting sputum culture results for critically ill pediatric patients with pneumonia |
| title_sort | diagnostic performance of the sputum gram stain in predicting sputum culture results for critically ill pediatric patients with pneumonia |
| topic | gram stain pediatric sputum culture |
| url | http://www.sciencedirect.com/science/article/pii/S1875957220300541 |
| work_keys_str_mv | AT wunyanhuang diagnosticperformanceofthesputumgramstaininpredictingsputumcultureresultsforcriticallyillpediatricpatientswithpneumonia AT mingshenglee diagnosticperformanceofthesputumgramstaininpredictingsputumcultureresultsforcriticallyillpediatricpatientswithpneumonia AT liangmeilin diagnosticperformanceofthesputumgramstaininpredictingsputumcultureresultsforcriticallyillpediatricpatientswithpneumonia AT yichenliu diagnosticperformanceofthesputumgramstaininpredictingsputumcultureresultsforcriticallyillpediatricpatientswithpneumonia |