An Urgent Problem of Aerobic Gram-Negative Pathogen Infectionin Complicated Parapneumonic Effusions or Empyema

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Title:	An Urgent Problem of Aerobic Gram-Negative Pathogen Infectionin Complicated Parapneumonic Effusions or Empyema
Authors:	林裕超(Yu-Chao Lin);涂智彥(Chih-Yen Tu);陳煒(Wei- Chen);蔡育霖(Yu-Lin Tsai);陳鴻仁(Hung-Jen Chen);徐武輝(Wu-Huei Hsu);施純明(Chuen-Ming Shih)*
Contributors:	健康照護學院二年制呼吸治療學系學士班在職專班;中國附醫內科部胸腔科
Keywords:	bacterial infection;complicated parapneumonic effusion;empyema
Date:	2007-08
Issue Date:	2010-09-23 19:50:44 (UTC+8)
Abstract:	OBJECTIVES: Complicated parapneumonic effusion or empyema is a troublesome disease with a high mortality. The most common involved microorganisms seem to have changed over recent decades, influenced by the introduction of new antibiotics, and the increase of immunocompromised hosts, and the elderly population. More epidemiological studies on the current bacteriology are needed to help us to empirically select adequate antibiotics. DESIGN: A retrospective study via chart review in a university-affiliated tertiary medical center was conducted to assess the underlying bacterial pathogens and outcome of patients with complicated parapneumonic effusions or empyemas. RESULTS: During the 43-month study period (from December 2000 to June 2004), 304 patients were diagnosed with complicated parapneumonic effusions or empyemas and the mortality of these patients was 23% (69/304). Among these 304 patients, a total of 292 microorganisms were cultured from the pleural fluid samples of 207 patients (to yield a positive microbiological culture rate of 68% (207/304). Isolated bacteria included aerobic Gram-negative bacteria (n=129), aerobic Gram-positive bacteria (n=105), anaerobic bacteria (n=51), and M. tuberculosis (n=7). Of these aerobic bacterial infections, Gram-negative bacteria were isolated more frequently from the older population and involved a significantly higher mortality rate and longer stay, compared to those with other bacteria (p=0.001 and p<0.001 respectively). CONCLUSION: The increasing incidence of infection with aerobic Gram-negative pathogens may cause more critical conditions in complicated parapneumonic effusions or empyemas.
Relation:	INTERNAL MEDICINE (46):1173-1178
Appears in Collections:	[Department of Respiratory Therapy] Journal articles

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