back to 2010, vol. 16, b. 3

Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312-773X (Online)
Issue:2010, vol. 16, book 3
Subject Collection: Medicine
Page: 20 - 22
DOI: 10.5272/jimab.1632010_20-22
Online date: July 21, 2010

J of IMAB 2010; 16(3):20-22
USEFULNESS OF SPUTUM GRAM STAIN AND CULTURE  FOR  DIAGNOSIS OFPNEUMONIA IN A GERIATRIC INSTITUTION
Jean-Jacques Lloveras, Mohamed-Issam Shukr, Claude Pinos, Anissa Lindoulsi, Philippe Grima
Centre de Reeducation Fonctionnelle, Bagneres de Luchon , FRANCE


ABSTRACT:
The value of bacteriological assessment of sputum samples is controversial during lower respiratory tract infections. We retrospectively studied sputum Gram stain and culture in a geriatric population during a two-year period. A total of 42 sputum samples were send to the laboratory; among them, 24 (57%) allowed a diagnosis with a predominant morphotype.
Gram positive and Gram negative were equally distributed, but staphylococci and pseudomonas were most frequently found, as it is usually reported in the setting of nosocomial infections.In geriatric units and in long-term care facilities, diagnostic tests for management of lower respiratory tract infections are rarely performed, but the ratio cost-efficacy of this bacteriological testing could be improved, if considered the shortness of evolution of  broncho-pulmonary infectious episodes.

Key words: pneumonia, geriatrics, sputum.

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REFERENCES:
1. MARRIE T.J.: Bronchitis and pneu­monia in: Infectious diseases in the aging: a clinical handbook; ed: TT Yoshikawa and DC Norman: Humana Press Totowa; 2001: 53-65
2. MADISON J.M.: Expectorated sputum for Community –acquired Pneumo­nia; a sacred cow. Arch Intern Med. 2004; 164: 1725-27
3. MUBARECKA S, DUCKWORTH H, CHEANG M et al: Use of diagnostic tests for presumed lower respiratory tract  infection in long-term care facilites. J Am Geriatr Soc. 2007; 55:1365-70
4. SACCHETTI R., APORTI M., BIANCO L. et al: Prospective observa­tional study of pneumonia in a Italian hospital.  Infez Med. 2008; 16:219-26.
5. WILBER S.T.: Geriatric pneumonia in: Geriatric Emergency Medicine; ed SW MELDON, OJ MA, R WOOLARD Mc Graw-Hill; 2004:144-53
6. MIYASHITA N, SHIMIZU H, OUCHI K et al: Assessment of the useful­ness of sputum Gram stain and culture for diagnosis of community-acquired pneumo­nia requiring hospita­lization. Med Sci Monit. 2008:14:CR 171-6.
7. GARCIA-VASQUEZ E, MARCOS MA, MENSA J et al: Assessment of the usefulness of sputum culture for  diagnosis of community-acquired pneumonia using the PORT predictive scoring system. Arch intern Med. 2004; 164:1807-11 [ PubMed ]
8. LEVY M, DROMER F, BRION N, LETURDU F, CARBON C. Community-acquired pneumonia; Importance of initial noninvasive bacteriological and radiographic investigations. Chest. 1988; 93:43-8 [PubMed]
9. ENDEMAN H, SCHELFHOUT V, VOORN GP, VAN VELZEN-BLAD H, GRUTTERS JC, BIESMA DH:  Clinical features predicting failure of pathogen identification in patients with community acquired Pneumonia. Scand J Infect Dis. 2008; 40:715-20
10. MUSHER DM: The usefulness of sputum Gram stain and culture. Arch Intern Med. 2005;165:470-471.
11. VALENTI WM, TRUDELL RG, BENTLEY DW: Factors predisposing to oropharyngeal colonization with gram- negative bacilli in the aged. N Engl J Med. 1978; 298:1108-11
12. EWIG S, SCHLOCHTERMEIER M, GOKE N., NIEDERMAN M: Applying sputum as a diagnostic tool in  pneumonia: Limited yield,minimal impact on treatment decisions. Chest. 2002; 121:1486-92 [PubMed]

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