Finland M, Barnes M W
J Infect Dis. 1978 Mar;137(3):274-91. doi: 10.1093/infdis/137.3.274.
The occurrence, etiology, and demography of acute bacterial empyema are presented to reflect the widespread use of sulfonamides, penicillin, and other active antibiotics. In community-acquired (C-A) cases Streptococcus pneumoniae, hemolytic streptococci, and Staphylococcus aureus were the most frequent single organisms identified in initial positive cultures of pleural fluid during 1935. S. pneumoniae declined steadily until 1953 but continued to occur frequently in C-A cases. Hemolytic streptococci became infrequent. S. aureus increased and became the most frequent organism in 1955 and declined to original levels after 1965 while gram-negative rods increased. S. aureus, aerobic gram-negative rods, and enterococci were most frequent in originally mixed infections, hospital-acquired cases, and superinfections. Anaerobes with or without aerobes were mostly seen in C-A cases and did not vary in incidence. Mortality increased with age. Overall mortality was greater during the 10 antibiotic years, associated with a marked decrease in the proportion of patients younger than 50 years and increase in those over 60 years old, and was greater in patients with serious underlying diseases subjected to more complicated surgical procedures.
本文介绍了急性细菌性脓胸的发病情况、病因及人口统计学特征，以反映磺胺类药物、青霉素及其他活性抗生素的广泛应用。在社区获得性（C-A）病例中，肺炎链球菌、溶血性链球菌和金黄色葡萄球菌是1935年胸腔积液初始阳性培养中最常见的单一病原体。肺炎链球菌在1953年之前持续下降，但在C-A病例中仍频繁出现。溶血性链球菌变得不常见。金黄色葡萄球菌增多，在1955年成为最常见的病原体，1965年后降至原来水平，而革兰氏阴性杆菌增多。金黄色葡萄球菌、需氧革兰氏阴性杆菌和肠球菌在最初的混合感染、医院获得性病例和二重感染中最为常见。有或无需氧菌的厌氧菌多见于C-A病例，发病率无变化。死亡率随年龄增长而增加。在使用抗生素的10年期间，总体死亡率更高，这与50岁以下患者比例显著下降以及60岁以上患者比例增加有关，并且在患有严重基础疾病且接受更复杂外科手术的患者中死亡率更高。
