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Utility of Gram Stain and Sputum Culture in the Management of Community-Acquired Pneumonia

2003; Lippincott Williams & Wilkins; Volume: 10; Issue: 1 Linguagem: Inglês

10.1097/00045413-200301000-00001

1536-5956

Beatriz Ros n, Francesc Gudiol,

Bacterial Infections and Vaccines

The clinical value of diagnostic testing in community-acquired pneumonia is still controversial, mainly because of the lack of prospective, controlled studies that specifically address this issue. This article reviews the utility of sputum Gram stain and culture in the management of these patients. Although with limited sensitivity, Gram stain is the most cost-effective diagnostic test available before initiation of antibiotic therapy in pneumonia. When the test is interpreted by skilled personnel, it provides reliable information on the etiology of bacterial pneumonia. It is highly specific for the diagnosis of pneumococcal and Haemophilus influenzae pneumonia and permits initial pathogen-oriented therapy. The sputum culture should be interpreted in the light of Gram stain results, except for specific pathogens such as Legionella. It provides etiologic diagnosis and allows susceptibility testing for resistant bacteria.