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Sputum colour and bacteria in chronic bronchitis exacerbations: a pooled analysis

Marc Miravitlles, Frank Kruesmann, Daniel Haverstock, Renee Perroncel, Shurjeel H. Choudhri, Pierre Arvis
European Respiratory Journal 2012 39: 1354-1360; DOI: 10.1183/09031936.00042111
Marc Miravitlles
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Frank Kruesmann
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Daniel Haverstock
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Renee Perroncel
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Shurjeel H. Choudhri
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Pierre Arvis
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Abstract

We examined the correlation between sputum colour and the presence of potentially pathogenic bacteria in acute exacerbations of chronic bronchitis (AECBs).

Data were pooled from six multicentre studies comparing moxifloxacin with other antimicrobials in patients with an AECB. Sputum was collected before antimicrobial therapy, and bacteria were identified by culture and Gram staining. Association between sputum colour and bacteria was determined using logistic regression.

Of 4,089 sputum samples, a colour was reported in 4,003; 1,898 (46.4%) were culture-positive. Green or yellow sputum samples were most likely to yield bacteria (58.9% and 45.5% of samples, respectively), compared with 18% of clear and 39% of rust-coloured samples positive for potentially pathogenic microorganisms. Factors predicting a positive culture were sputum colour (the strongest predictor), sputum purulence, increased dyspnoea, male sex and absence of fever. Green or yellow versus white sputum colour was associated with a sensitivity of 94.7% and a specificity of 15% for the presence of bacteria.

Sputum colour, particularly green and yellow, was a stronger predictor of potentially pathogenic bacteria than sputum purulence and increased dyspnoea in AECB patients. However, it does not necessarily predict the need for antibiotic treatment in all patients with AECB.

  • Acute exacerbations of chronic bronchitis
  • bacteria
  • chronic obstructive pulmonary disease
  • sputum colour

Footnotes

  • Support Statement

    This study was funded by Bayer Schering Pharma. Highfield Communication Consultancy, funded by Bayer Shering Pharma, provided editorial assistance in the preparation of this manuscript.

  • Statement of Interest

    Statements of interest for all authors and for the study itself can be found at www.erj.ersjournals.com/site/misc/statements.xhtml

  • Received March 8, 2011.
  • Accepted October 3, 2011.
  • ©ERS 2012
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Sputum colour and bacteria in chronic bronchitis exacerbations: a pooled analysis
Marc Miravitlles, Frank Kruesmann, Daniel Haverstock, Renee Perroncel, Shurjeel H. Choudhri, Pierre Arvis
European Respiratory Journal Jun 2012, 39 (6) 1354-1360; DOI: 10.1183/09031936.00042111

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Sputum colour and bacteria in chronic bronchitis exacerbations: a pooled analysis
Marc Miravitlles, Frank Kruesmann, Daniel Haverstock, Renee Perroncel, Shurjeel H. Choudhri, Pierre Arvis
European Respiratory Journal Jun 2012, 39 (6) 1354-1360; DOI: 10.1183/09031936.00042111
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