Expectorated Sputum for Community-Acquired Pneumonia

Madison, J. Mark; Irwin, Richard S.

doi:10.1001/archinte.164.16.1725

Cited by 11 publications

(6 citation statements)

References 22 publications

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“…Sputum culture is the gold standard for identifying pathogenic bacteria in patients with pneumonia, but the proper acquisition of sputum culture is sometimes difficult, and the results of sputum culture may not reflect the exact microbiome of pneumonia lesions in the lung. In addition, certain bacterial species, such as obligate anaerobes, Mycoplasma pneumoniae, and Legionella pneumophila, are difficult to culture [2], and sputum culture can clinically infer only approximately 40% of causative pathogens in patients with pneumonia [3].…”

Section: Introductionmentioning

confidence: 99%

Comparative study of bacterial flora in bronchoalveolar lavage fluid of pneumonia patients based on their pneumonia subtypes and comorbidities using 16S ribosomal RNA gene analysis

Nemoto

Yatera

Akata

et al. 2022

Journal of Infection and Chemotherapy

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Section: Introductionmentioning

confidence: 99%

Comparative study of bacterial flora in bronchoalveolar lavage fluid of pneumonia patients based on their pneumonia subtypes and comorbidities using 16S ribosomal RNA gene analysis

Nemoto

Yatera

Akata

et al. 2022

Journal of Infection and Chemotherapy

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“…Sputum examinations are widely used common methods for evaluating the causative pathogens of bacterial pneumonia. Due to unavoidable contamination with the upper respiratory tract, expectorated sputum samples are occasionally inadequate for identifying causative pathogens [ 9 ]. The increase in the number of elderly patients may also lead to an increase in the rate of etiologically unknown pathogens in pneumonia, as Cillóniz et al .…”

Section: Introductionmentioning

confidence: 99%

Bacteriological Assessment of Healthcare-Associated Pneumonia Using a Clone Library Analysis

et al. 2015

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BackgroundThe causative pathogens of healthcare-associated pneumonia (HCAP) remain controversial, and the use of conventional cultivation of sputum samples is occasionally inappropriate due to the potential for oral bacterial contamination. It is also sometimes difficult to determine whether methicillin-resistant Staphylococcus aureus (MRSA) is a true causative pathogen of HCAP.MethodsWe evaluated the bacterial diversity in bronchoalveolar lavage fluid (BALF) using molecular and cultivation methods in 82 HCAP patients. BALF specimens were obtained from the lesions of pneumonia using bronchoscopy. The bacterial flora was analyzed according to the clone library method using amplified fragments of the 16S ribosomal RNA gene with universal primers. In addition, sputum cultures and the above specimens were assessed.ResultsEighty (97.6%) of the 82 BALF samples obtained from the patients with HCAP showed positive polymerase chain reaction results. The predominant phylotypes detected in the BALF in this study included bacteria common in cases of community- and hospital-acquired pneumonia. In addition, the phylotypes of streptococci and anaerobes were detected in 19 (23.2%) and 8 (9.8%) cases, respectively. In particular, phylotypes of streptococci were highly detected among the patients 75 of age or older. Staphylococcus aureus was cultured in 23 (28.0%) cases using conventional cultivation methods and detected in only 6 (7.3%) cases as predominant phylotypes according to the clone library method.ConclusionsThe clone library analysis of BALF in the HCAP patients detected heterogeneous bacteria and a high incidence of streptococci compared with that observed using cultivation methods. In addition, the results of our study may indicate a lower incidence of MRSA than previously expected in HCAP patients.

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“…A confounding factor in the existing studies that may skew toward a higher prevalence of MDR organisms is that resistant organisms may be easier to grow in culture than more common organisms, such as S pneumoniae, which distorts the data. 30 In an effort to identify those at risk for MDR organisms, in 2005 the IDSA/ATS created the health care-associated pneumonia (HCAP) classification, which included patients who had been hospitalized in the past 90 days, resided at a long-term care facility, received intravenous antibiotics, chemotherapy, or wound care within the past 30 days. 31 Because of the introduction of the HCAP classification, the use of broad-spectrum antibiotics has increased significantly; but that classification has come under scrutiny because of its inconsistent ability to predict the presence of MDR organisms.…”

Section: Who Is At Risk For Multidrug-resistant Organisms?mentioning

confidence: 99%