PT  - JOURNAL ARTICLE
AU  - Marc Miravitlles
AU  - Frank Kruesmann
AU  - Daniel Haverstock
AU  - Renee Perroncel
AU  - Shurjeel H. Choudhri
AU  - Pierre Arvis
TI  - Sputum colour and bacteria in chronic bronchitis exacerbations: a pooled analysis
AID  - 10.1183/09031936.00042111
DP  - 2012 Jun 01
TA  - European Respiratory Journal
PG  - 1354--1360
VI  - 39
IP  - 6
4099  - http://erj.ersjournals.com/content/39/6/1354.short
4100  - http://erj.ersjournals.com/content/39/6/1354.full
SO  - Eur Respir J2012 Jun 01; 39
AB  - 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.