RT Journal Article
SR Electronic
T1 Sputum colour and bacteria in chronic bronchitis exacerbations: a pooled analysis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1354
OP 1360
DO 10.1183/09031936.00042111
VO 39
IS 6
A1 Marc Miravitlles
A1 Frank Kruesmann
A1 Daniel Haverstock
A1 Renee Perroncel
A1 Shurjeel H. Choudhri
A1 Pierre Arvis
YR 2012
UL http://erj.ersjournals.com/content/39/6/1354.abstract
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.