Boerner D F, Zwadyk P
JAMA. 1982 Feb 5;247(5):642-5.
Expectorated sputum Gram's stain was correlated with clinical presenting data, cultures, serological data, and response to antibiotic therapy in 89 patients admitted with community-acquired pneumonia. The finding of Gram-positive diplococci on Gram's stain correlated with brief antecedent illness, Streptococcus pneumoniae growing from cultures, and a rapid response to single-agent antibiotic therapy. Patients with no predominant pathogen on Gram's stain were clinically indistinguishable from those with Gram-positive diplococci except for a longer antecedent illness, lack of growth of pathogens from cultures, and more prolonged response to antibiotic therapy. Sputum cytological findings and transtracheal cultures were useful in patients with no Gram-positive diplococci on Gram's stain. The sputum Gram's stain is proposed as a sensitive and reliable indicator to guide therapy and predict outcome in adults with community-acquired pneumonia.
对89例社区获得性肺炎患者的咳出痰液进行革兰氏染色，并将其与临床症状数据、培养结果、血清学数据以及抗生素治疗反应进行关联分析。革兰氏染色发现革兰氏阳性双球菌与前驱疾病短暂、培养出肺炎链球菌以及对单药抗生素治疗反应迅速相关。革兰氏染色未发现主要病原体的患者，除了前驱疾病时间较长、培养未生长出病原体以及对抗生素治疗反应时间较长外，在临床上与革兰氏阳性双球菌患者无法区分。对于革兰氏染色未发现革兰氏阳性双球菌的患者，痰液细胞学检查结果和经气管培养很有用。痰液革兰氏染色被认为是指导成人社区获得性肺炎治疗和预测预后的敏感且可靠指标。
