Hjertman Jakob, Bläckberg Jonas, Ljungquist Oskar
Department of Infectious Diseases, Helsingborg hospital, Helsingborg, Sweden.
Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.
Infect Dis (Lond). 2022 Mar;54(3):163-169. doi: 10.1080/23744235.2021.1985165. Epub 2021 Oct 4.
The incidence of community-acquired pleural empyema is increasing. Knowledge of the bacterial aetiology is important in order to base recommendations on empirical antimicrobial treatment. The primary aim of the present study was to describe the bacterial aetiology of adult patients with culture proven and/or 16S rRNA-positive community-acquired pleural infection.
We performed a retrospective, population-based observational cohort study in Skåne County, south of Sweden. We included all patients with pleural samples obtained between 1st of January 2011 to 31st of December 2017 in Skåne, south of Sweden, with a positive culture and/or 16S rRNA result. Exclusion criteria were patients with culture-negative and/or 16S rRNA-negative pleural samples, age < 18 years, pleural empyema caused by trauma or iatrogenesis, pleural infection caused by tuberculosis or fungi, simultaneous lung- or abscess of the abdomen and bacterial species considered to be contaminants.
A total of 291 patients were included in the study, of which 63% were men and the median age was 69 years. The dominating bacterial aetiology was viridans streptococci (36%), followed by (14%) and anaerobic bacteria (12%). 16S rRNA added information of bacterial aetiology in addition to standard culturing methods in 63% of the patients.
We found that the aetiology of adult patients with culture proven and/or 16S rRNA-positive community-acquired pleural empyema is dominated by viridans streptococci, and anaerobic bacteria. Our study shows that 16S rRNA is a valuable tool in finding the bacterial aetiology of community-acquired pleural empyema.
社区获得性胸膜腔积脓的发病率正在上升。了解细菌病因对于基于经验性抗菌治疗提出建议很重要。本研究的主要目的是描述经培养证实和/或16S rRNA阳性的社区获得性胸膜感染成年患者的细菌病因。
我们在瑞典南部的斯科讷县进行了一项基于人群的回顾性观察队列研究。我们纳入了2011年1月1日至2017年12月31日期间在瑞典南部斯科讷获得胸膜样本且培养和/或16S rRNA结果为阳性的所有患者。排除标准为培养阴性和/或16S rRNA阴性的胸膜样本患者、年龄<18岁、由创伤或医源性因素引起的胸膜腔积脓、由结核或真菌引起的胸膜感染、同时存在肺部或腹部脓肿以及被认为是污染物的细菌种类。
共有291名患者纳入研究，其中63%为男性，中位年龄为69岁。主要的细菌病因是草绿色链球菌（36%），其次是[此处原文缺失部分内容]（14%）和厌氧菌（12%）。在63%的患者中，除标准培养方法外，16S rRNA还增加了细菌病因的信息。
我们发现，经培养证实和/或16S rRNA阳性的社区获得性胸膜腔积脓成年患者的病因以草绿色链球菌、[此处原文缺失部分内容]和厌氧菌为主。我们的研究表明，16S rRNA是发现社区获得性胸膜腔积脓细菌病因的一种有价值的工具。
