Is there a real need for sputum culture for community-acquired pneumonia diagnostics? Results from a retrospective study in Russia
-
Olga S. Kobyakova
,
Ivan A. Deev
,
Daria A. Vinokurova
,
Anastasia P. Zima
,
Denis S. Tyufilin
,
Vera E. Yun
,
Ekaterina A. Chernysheva
,
Nikolay D. Yarovoy
,
Ksenia R. Ratkina
,
Anna I. Shemuratova
,
Emmanuel U. Agbo
,
Kristina V. Kulikova
,
Ekaterina K. Tagina
und
Evgeny S. Kulikov
Abstract
Objectives
The mortality rate associated with community-acquired pneumonia is still considered high as it occupies a leading position among all infectious diseases. The primary purpose of this study is to evaluate the implementation of the respiratory bacterial culture sampling in the clinical practice of the Russian Federation’s therapeutic departments and its impact on inpatient care.
Methods
The study included 1,344 patients with community-acquired pneumonia. The analysis of the obtained data was performed using the statistical software package SPSS 23.0 (IBM SPSS Statistics). The description of quantitative indicators was carried out with an indication of the median (25; 75 percentile). Qualitative with an indication of the absolute and relative frequencies n (%).
Results
It was noted that a third of the sample did not pass through the first stage (bacterioscopy). We noticed the predominance of oropharyngeal flora in the results. The sputum collection was carried out on average 3 (1; 5) days after the start of hospitalization, while antibiotic therapy was prescribed to all patients on the first day, the results of the bacteriological study were ready on average 6 (4; 8th) calendar days after hospitalization, while in 20 (1.5%) cases, the patient was already discharged. Due to the inefficiency of the starting regimen, antimicrobial agents have changed in 84 (6.3%) patients and averaged 5.5 (4.0; 10.0) days from the start of hospitalization.
Conclusions
The violation of the technique and the time of sputum collection resulted in a reduction in the method’s value.
-
Research funding: None declared.
-
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
-
Competing interests: Authors state no conflict of interest.
-
Ethical approval: The Ethics Committee of the Siberian State Medical University approved the study; Committee Conclusion No. 5789 of February 26, 2018.
References
1. World Health Organization. The top 10 causes of death. May 24, 2018. [Online]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death [Accessed 27 Feb 2020].Suche in Google Scholar
2. Center for Disease Dynamics, Economics and policy. The state of the world’s antibiotics 2015. Sep 18, 2015. [Online]. Available from: https://cddep.org/wp-content/uploads/2017/06/swa_edits_9.16.pdf [Accessed 27 Feb 2020].Suche in Google Scholar
3. European Centre for Disease Prevention and Control. Surveillance of antimicrobial resistance in Europe 2017. Nov 15, 2018. [Online]. Available from: https://ecdc.europa.eu/sites/portal/files/documents/EARS-Net-report-2017-update-jan-2019.pdf [Accessed 27 Feb 2020].Suche in Google Scholar
4. Ministry of Health Care of the Russian Federation. Order of the Ministry of Health Care of the Russian Federation ‘about approval of the procedure for the organization of rendering specialized medical care for patients with severe pneumonia and its complications’ No. 741n November 09, 2012. Jan 17, 2013. [Online]. Available from: https://www.rosminzdrav.ru/documents/8974-prikaz-ministerstva-zdravoohraneniya-rossiyskoy-federatsii-ot-9-noyabrya-2012-g-741n-ob-utverzhdenii-standarta-spetsializirovannoy-meditsinskoy-pomoschi-pri-pnevmonii-tyazheloy-stepeni-tyazhesti-s-oslozhneniyami [Accessed 27 Feb 2020].Suche in Google Scholar
5. Ministry of Health Care of the Russian Federation. Order of the Ministry of Health Care of the Russian Federation ‘about approval of the Procedure for the organization of rendering specialized medical care for patients with moderate pneumonia’ No. 741n December 29, 2012. Feb 13, 2013. [Online]. Available from: https://www.rosminzdrav.ru/documents/9006-prikaz-ministerstva-zdravoohraneniya-rossiyskoy-federatsii-ot-29-dekabrya-2012-g-1658n-ob-utverzhdenii-standarta-spetsializirovannoy-meditsinskoy-pomoschi-pri-pnevmonii-sredney-stepeni-tyazhesti [Accessed 27 Feb 2020].Suche in Google Scholar
6. Ogawa, H, Kitsios, GD, Iwata, M, Terasawa, T. Sputum Gram stain for bacterial pathogen diagnosis in community-acquired pneumonia: a systematic review and bayesian meta-analysis of diagnostic accuracy and yield. Clin Infect Dis 2020;71:499–513. https://doi.org/10.1093/cid/ciz876.Suche in Google Scholar PubMed PubMed Central
7. Carugati, M, Aliberti, S, Reyes, LF, Franco Sadud, R, Irfan, M, Prat, C, et al. Microbiological testing of adults hospitalized with community-acquired pneumonia: an international study. ERJ Open Res 2018;4:00096-2018. https://doi.org/10.1183/23120541.00096-2018.Suche in Google Scholar PubMed PubMed Central
8. García-Vázquez, E, Marcos, MA, Mensa, J, de Roux, A, Puig, J, Font, C, 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. https://doi.org/10.1001/archinte.164.16.1807.Suche in Google Scholar PubMed
9. Laboratornaya diagnostika vnebol’nichnykh pnevmoniy. Metodicheskiye ukazaniya [Laboratory diagnosis of community-acquired pneumonia: guidelines]. Moscow: Federal Center for Hygiene and Epidemiology of Federal Service on Surveillance for Consumer Rights Protection and Human Well-Being; 2014:39 p.Suche in Google Scholar
10. Chuchalin, AG, Sinopal’nikov, AI, Kozlov, RS, Avdeev, SN, Tyurin, IE, Rudnov, VA, et al. Russian Respiratory Society Interregional Association on clinical microbiology and antimicrobial chemotherapy. Clinical guidelines on diagnosis, treatment and prevention of severe community acquired pneumonia in adults. Russ Pulmonol 2014;4:13–48. https://doi.org/10.18093/0869-0189-2014-0-4-13-48 (In Russian).Suche in Google Scholar
11. Musher, DM, Montoya, R, Wanahita, A. Diagnostic value of microscopic examination of gram-stained sputum and sputum cultures in patients with bacteremic pneumococcal pneumonia. Clin Infect Dis 2004;39:165–9. https://doi.org/10.1086/421497.Suche in Google Scholar PubMed
12. Harris, AM, Bramley, AM, Jain, S, Arnold, SR, Ampofo, K, Self, WH, et al. Influence of antibiotics on the detection of bacteria by culture-based and culture-independent diagnostic tests in patients hospitalized with community-acquired pneumonia. Open Forum Infect Dis 2017;4:ofx014. https://doi.org/10.1093/ofid/ofx014.Suche in Google Scholar PubMed PubMed Central
13. Saukkoriipi, A, Palmu, AA, Jokinen, J, Verlant, V, Hausdorff, WP, Kilpi, TM. Effect of antimicrobial use on pneumococcal diagnostic tests in elderly patients with community-acquired pneumonia. Eur J Clin Microbiol Infect Dis 2015;34:697–704. https://doi.org/10.1007/s10096-014-2278-5.Suche in Google Scholar PubMed
14. Rhodes, J, Hyder, JA, Peruski, LF, Fisher, C, Jorakate, P, Kaewpan, A, et al. Antibiotic use in Thailand: quantifying impact on blood culture yield and estimates of pneumococcal bacteremia incidence. Am J Trop Med Hyg 2010;83:301–6. https://doi.org/10.4269/ajtmh.2010.09-0584.Suche in Google Scholar PubMed PubMed Central
© 2020 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- Chest pain management and biomarkers: the lack of trust in cardiac troponins measurement
- Reviews
- Bringing the clinical laboratory into the strategy to advance diagnostic excellence
- Atrial fibrillation: is there a role for cardiac troponin?
- Opinion Papers
- Towards better metainterpretation: improving the clinician’s interpretation of the radiology report
- The challenges of diagnosing diabetes in childhood
- Guidelines and Recommendations
- Measuring patient experience of diagnostic care and acceptability of testing
- Original Articles
- Clinical assessment of the Roche SARS-CoV-2 rapid antigen test
- Delayed treatment of bacteremia during the COVID-19 pandemic
- Strengths and weaknesses in the diagnostic process of endometriosis from the patients’ perspective: a focus group study
- Identifying trigger concepts to screen emergency department visits for diagnostic errors
- Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors
- Uncertain diagnoses in a children’s hospital: patient characteristics and outcomes
- The effects of rudeness, experience, and perspective-taking on challenging premature closure after pediatric ICU physicians receive hand-off with the wrong diagnosis: a randomized controlled simulation trial
- Resident-faculty overnight discrepancy rates as a function of number of consecutive nights during a week of night float
- CONUT: a tool to assess nutritional status. First application in a primary care population
- Is there a real need for sputum culture for community-acquired pneumonia diagnostics? Results from a retrospective study in Russia
- Differentiating solid breast masses: comparison of the diagnostic efficacy of shear wave elastography and magnetic resonance imaging
- Short Communication
- Chest pain management: use of troponins in internal medicine wards
- Case Report
- Learning from tragedy – The Jessica Barnett story: challenges in the diagnosis of long QT syndrome
- Letters to the Editor
- Usability of non-medicinal swabs for SARS-CoV-2 detection to circumvent supply shortages
- Medical decision making during the COVID-19 epidemic: an opportunity to think how we think
Artikel in diesem Heft
- Frontmatter
- Editorial
- Chest pain management and biomarkers: the lack of trust in cardiac troponins measurement
- Reviews
- Bringing the clinical laboratory into the strategy to advance diagnostic excellence
- Atrial fibrillation: is there a role for cardiac troponin?
- Opinion Papers
- Towards better metainterpretation: improving the clinician’s interpretation of the radiology report
- The challenges of diagnosing diabetes in childhood
- Guidelines and Recommendations
- Measuring patient experience of diagnostic care and acceptability of testing
- Original Articles
- Clinical assessment of the Roche SARS-CoV-2 rapid antigen test
- Delayed treatment of bacteremia during the COVID-19 pandemic
- Strengths and weaknesses in the diagnostic process of endometriosis from the patients’ perspective: a focus group study
- Identifying trigger concepts to screen emergency department visits for diagnostic errors
- Handshake antimicrobial stewardship as a model to recognize and prevent diagnostic errors
- Uncertain diagnoses in a children’s hospital: patient characteristics and outcomes
- The effects of rudeness, experience, and perspective-taking on challenging premature closure after pediatric ICU physicians receive hand-off with the wrong diagnosis: a randomized controlled simulation trial
- Resident-faculty overnight discrepancy rates as a function of number of consecutive nights during a week of night float
- CONUT: a tool to assess nutritional status. First application in a primary care population
- Is there a real need for sputum culture for community-acquired pneumonia diagnostics? Results from a retrospective study in Russia
- Differentiating solid breast masses: comparison of the diagnostic efficacy of shear wave elastography and magnetic resonance imaging
- Short Communication
- Chest pain management: use of troponins in internal medicine wards
- Case Report
- Learning from tragedy – The Jessica Barnett story: challenges in the diagnosis of long QT syndrome
- Letters to the Editor
- Usability of non-medicinal swabs for SARS-CoV-2 detection to circumvent supply shortages
- Medical decision making during the COVID-19 epidemic: an opportunity to think how we think
