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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