Microbiological Characteristics and Predictive Factors for Mortality in Pleural Infection: A Single-Center Cohort Study in KoreaReport as inadecuate




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Background

Identification and understanding of the pathogens responsible for pleural infection is critical for appropriate antibiotic treatment. This study sought to determine the microbiological characteristics of pleural infection and to identify potential predictive factors associated with mortality.

Methods

In this retrospective study, we analyzed patient data from 421 cases of parapneumonic effusion. A total of 184 microorganisms were isolated from 164 patients, using two culture systems: a standard method and a method using pairs of aerobic and anaerobic blood culture bottles.

Results

The most frequently isolated microorganisms were streptococci 31.5%, followed by staphylococci 23.4%, gram-negative bacteria 18.5% and anaerobes 10.3%. Streptococci were the main microorganisms found in standard culture 41.9% and community-acquired infections 52.2%, and were susceptible to all antimicrobial agents in drug sensitivity testing. Staphylococci were the most frequently isolated pathogens in blood cultures 30.8% and hospital-acquired infections 38.3%, and were primarily multidrug-resistant 61.8%. In multivariate analysis, the following were significant predictive factors for 30-day mortality among the total population: CURB-65 ≥ 2 aOR 5.549, 95% CI 2.296–13.407, p<0.001, structural lung disease aOR 2.708, 95% CI 1.346–5.379, p = 0.004, PSI risk class IV-V aOR 4.714, 95% CI 1.530–14.524, p = 0.007, no use of intrapleural fibrinolytics aOR 3.062, 95% CI 1.102–8.511, p = 0.014, hospital-acquired infection aOR 2.205, 95% CI 1.165–4.172, p = 0.015, age aOR 0.964, 95% CI 0.935–0.994, p = 0.018, and SOFA score ≥2 aOR 2.361, 95% CI 1.134–4.916, p = 0.022.

Conclusion

In this study, common pathogens causing pleural infection were comparable to previous studies, and consisted of streptococci, staphylococci, and anaerobes. CURB-65 ≥2, structural lung disease, PSI risk class IV-V, no use of intrapleural fibrinolytics, hospital-acquired infection, older age, and SOFA score ≥ 2 are potential predictors of mortality in pleural infection.



Author: Cheol-Kyu Park, Hyoung-Joo Oh, Ha-Young Choi, Hong-Joon Shin, Jung Hwan Lim, In-Jae Oh, Yu-Il Kim, Sung-Chul Lim, Young-Chul Kim,

Source: http://plos.srce.hr/



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