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) |