Skip to main content

Table 1 Characteristics of Studies Included in the Meta-Analysis

From: Usefulness of sputum gram stain for etiologic diagnosis in community-acquired pneumonia: a systematic review and meta-analysis

Author Year Journal Patients Definition of positive Gram stain Definition of good quality sample Number of samples Microorganism Sensitivity (95% CI) Specificity (95% CI)
Merrill, et al. [14] 1973 N Engl J Med 27 Unknown Unknown 53 S. pneumoniae 96 (81–100) 12 (2–30)
       30 S. pneumoniae 43 (18–71) 88 (62–98)
Thorsteinsson, et al. [15] 1975 JAMA 16 Unknown Unknown 16 S. pneumoniae 100 (75–100) 67 (9–99)
        S. pneumoniae 100 (75–100) 67 (9–99)
        S. pneumoniae 100 (75–100) 67 (9–99)
        H. influenzae 100 (40–100) 100 (74–100)
Rein, et al. [16] 1978 JAMA 42 Preponderant flora or > 10/oif At least 10 PMN leukocytes 42 S. pneumoniae 62 (42–79) 85 (55–98)
Boerner, et al. [17] 1982 JAMA 89 > 50% of the same morphotype PMN leukocytes in excess of epithelial cell 76 S. pneumoniae 62 (42–79) 85 (55–98)
Dans, et al. [18] 1984 Arch Intern Med 241 Unknown Used a ratio of PMN leukocytes:epithelial cells 154 S. pneumoniae 52 (40–65) 88 (79–94)
       147 S. pneumoniae 63 (48–76) 80 (71–88)
BTS. [20] 1987 QJM 511 > 50% of the same morphotype Unknown 404 S. pneumoniae 15 (9–22) 98 (96–99)
Lentino, et al. [19] 1987 J Clin Microbiol 249 > 50% of the same morphotype > 25 leukocytes and < 10 epithelial cells 40 S. pneumoniae 56 (31–78) 95 (77–100)
Gleckman, et al. [21] 1988 J Clin Microbiol 144 > 10/oif of the same morphotype > 25 leukocytes and < 10 epithelial cells 59 S. pneumoniae 69 (52–84) 83 (61–95)
Xiaoping, et al. [22] 1988 Med Microbiol Inmmunol 105 > 10/oif of the same morphotype > 25 leukocytes and < 10 epithelial cells 95 S. pneumoniae 88 (62–98) 85 (75–92)
Lim, et al. [23] 1989 Med J Aust 106 > 50% of the same morphotype or > 10/oif Unknown 40 S. pneumoniae 68 (48–84) 100 (74–100)
Fine, et al. [24] 1991 J Gen Intern Med 170 > 50% of the same morphotype > 25 leukocytes and < 10 epithelial cells 36 S. pneumoniae 86 (42–100) 72 (53–87)
Belliveau, et al. [25] 1993 Pharmacotherapy 224 Unknown Number of neutrophils and epithelial cells 319 H. influenzae 88 (68–97) 99 (97–100)
Bohte, et al. [26] 1996 Eur J Clin Microbiol Infect Dis 268 Unknown > 25 leukocytes and < 10 epithelial cells 268 S. pneumoniae 65 (53–75) 76 (69–82)
Rosón, et al. [27] 2000 Clin Infect Dis 533 > 75% of the same morphotype > 25 leukocytes and < 10 epithelial cells 210 S. pneumoniae 57 (46–68) 97 (92–99)
        H. influenzae 82 (65–93) 100 (97–100)
Ewig, et al. [5] 2001 Chest 116 Predominant morphotype Used a score 23 S. pneumoniae 50 (7–93) 84 (60–97)
        H. influenzae 0 (0–60) 0 (0–18)
        S. aureus 50 (1–99) 81 (58–95)
Musher, et al. [28] 2004 Clin Infect Dis 105 Unknown 10 leukocytes for each epithelial cell 105 S. pneumoniae 31 (23–41) NA
Miyashita, et al. [29] 2008 Med Sci Monit 347 > 50% of the same morphotype > 25 leukocytes and < 10 epithelial cells 124 S. pneumoniae 68 (52–82) 94 (86–98)
        H. influenzae 78 (52–94) 100 (97–100)
Anevlavis, et al. [30] 2009 J Infect 1390 > 50% of the same morphotype Sum of two scores > 1 178 S. pneumoniae 82 (72–89) 93 (85–97)
        H. influenzae 79 (59–92) 96 (91–99)
        Gram negative 78 (60–91) 95 (90–98)
        S. aureus 76 (55–91) 96 (92–99)
Ferré, et al. [31] 2011 Emergencias 608 > 75% of the same morphotype > 25 leukocytes and < 10 epithelial cells 294 S. pneumoniae 47 (39–56) 94 (89–97)
       169 H. influenzae 73 (52–88) 95 (90–98)
Fukuyama, et al. [6] 2014 BMC Infect Dis 328 > 10/oif of the same morphotype < 10/oif epithelial cells and > 10/oif PMN 218 S. pneumoniae 66 (52–78) 89 (84–94)
        H. influenzae 78 (64–88) 95 (90–97)
        K. pneumoniae 50 (12–88) 100 (97–100)
        P. aeruginosa 22 (3–60) 100 (98–100)
        S. aureus 50 (1–99) 100 (98–100)
  1. Abbreviations: oif oil immersion field, PNM polymorphonuclear
\