Roxburgh C S D, Youngson G G
Department of Paediatric Surgery, Royal Aberdeen Children's Hospital, Westburn Road, Aberdeen.
Scott Med J. 2007 Nov;52(4):25-7. doi: 10.1258/rsmsmj.52.4.25.
The incidence of paediatric empyema is rising in the United Kingdom and North America. The reasons for increasing admissions are unclear. Management in tertiary units is often required. We report our experience in North-East Scotland over the last 15 years.
Empyema patients <15 yrs admitted to the Royal Aberdeen Children's Hospital between 1 st January 1990 and 1st June 2006 were identified using discharge coding. Data was collated from case notes. Patient characteristics, microbiology results, hospital stay and management are studied.
Twenty eight children (M:F = 1:1) were admitted. Mean age = 6.8 yrs. Twenty seven out of twenty eight presented with localising respiratory symptoms or signs. In 12/28 an organism was isolated. Streptococcus pneumoniae was the commonest isolate, and where polymerase chain reaction (PCR) testing was employed, 3/3 cases were serotype 1. Fourteen out of twenty eight required surgery: open (8/14) or thoracoscopic (6/14) decortication. Two thoracoscopic cases proceded to open decortication. No complications were observed. Mean hospital stay = 11.4 days. Twelve were managed in high dependency unit (HDU) with a mean stay of 7.1 days.
We demonstrate similar trends in North-East Scotland to those reported elsewhere. Serotype 1 streptococcus pneumoniae is the most isolated. Multi-drug resistance is not seen in our population. A surveillance programme is now established and reasons for the increasing incidence should become apparent.
在英国和北美，小儿脓胸的发病率正在上升。入院人数增加的原因尚不清楚。通常需要在三级医疗单位进行治疗。我们报告过去15年在苏格兰东北部的经验。
通过出院编码确定1990年1月1日至2006年6月1日期间入住阿伯丁皇家儿童医院的15岁以下脓胸患者。从病历中整理数据。研究患者特征、微生物学结果、住院时间和治疗情况。
28名儿童（男：女 = 1：1）入院。平均年龄 = 6.8岁。28名患者中有27名出现定位性呼吸道症状或体征。28例中有12例分离出病原体。肺炎链球菌是最常见的分离菌，采用聚合酶链反应（PCR）检测的3例中，3/3为1型血清型。28例中有14例需要手术：开放（8/14）或胸腔镜（6/14）剥脱术。2例胸腔镜手术转为开放剥脱术。未观察到并发症。平均住院时间 = 11.4天。12例在高依赖病房（HDU）治疗，平均住院时间为7.1天。
我们在苏格兰东北部发现了与其他地方报道的类似趋势。1型肺炎链球菌是最常分离出的菌株。我们的人群中未发现多重耐药情况。现已建立监测计划，发病率上升的原因应该会变得明显。
