Chest
Clinical InvestigationsPneumoniaApplying Sputum as a Diagnostic Tool in Pneumonia: Limited Yield, Minimal Impact on Treatment Decisions
Section snippets
Study Hypothesis
The study was part of a follow-up interventional evaluation of the management of patients with CAP at the Dreifaltigkeits-Krankenhaus in Wesseling, a primary-care hospital with about 200 beds.16 One part of the intervention consisted of evaluation of sputum samples as a diagnostic tool. The study hypothesis was that the sampling of sputum in this setting would result in a low diagnostic yield with a minimal impact on antimicrobial treatment decisions. The other part of the study included the
General Patient Characteristics and Outcome
The patient population included 72 men and 44 women (62% and 34%, respectively). Mean age was 68 ± 16 years (range, 24 to 96 years), including 82 elderly patients (71%; age ≥ 65 years) of whom 50 patients (43%) were very elderly (age ≥ 75 years). Twenty-four patients (21%) were admitted to the hospital from nursing homes. At least one comorbidity (cardiac, pulmonary, hepatic, renal, CNS, diabetes mellitus, or neoplastic as previously defined18) was present in 103 patients (89%). Using the
Discussion
The present study demonstrates the limited value of sputum as a diagnostic tool in the initial evaluation of patients with CAP admitted to a primary-care hospital. The limitations include failure to obtain a sputum sample from most patients, delay in collection and laboratory processing of samples, low diagnostic yield, and minimal impact on therapeutic decisions.
Of the 42 sputum samples collected from this population of 116 patients, only 23 samples (55%) were valid when standard microscopic
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2019, Clinical Microbiology and InfectionCitation Excerpt :Despite numerous studies investigating sputum cultures for pneumonia management, the utility of such cultures remains unclear [1,2], and understanding their economic value may help determine their usefulness.