An Urgent Problem of Aerobic Gram-Negative Pathogen Infection in Complicated Parapneumonic Effusions or Empyemas

Lin, Yu‐Wei; Tu, Chih Yeh; Chen, Wei; Tsai, Yu Lin; Chen, Hung Jen; Hsu, Wu Huei; Shih, Chuen Ming

doi:10.2169/internalmedicine.46.6451

Cited by 21 publications

(14 citation statements)

References 16 publications

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“…They reported a positive microbiological culture rate of 68%. We found that patient demographics in the study of Lin et al (2007) were similar to those in the present study (mean age ± standard deviation: 60.3 ± 18.6 vs. 60.7 ± 16.6 years; percentages of men: 74.8% vs. 76.5%), when we restricted our patients to the same hospital level and study period. Third, we cannot distinguish whether patients in low-caseload hospitals receive few procedures appropriately or inappropriately because of the inherent limitation regarding the lack of more specific diagnostic coding for the surgical indications of pleural infection, such as loculated effusions.…”

Section: Discussionsupporting

confidence: 69%

“…Fifth, the timing of life-support measures is unavailable in the database; therefore, we cannot distinguish life-saving emergency care from lifeprolonging measures for dying patients. Finally, the generalizability of the findings to other regions of the world may be limited because Taiwan has a distinctively high rate of Klebsiella pneumoniae pleural infection (Lin et al 2007). Therefore, further research is needed to confirm or refute our findings.…”

Section: Discussionmentioning

confidence: 99%

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Higher Hospital Caseload Is Associated with Better Treatment Outcomes of Patients with Pleural Infection

Shen

2014

Tohoku J. Exp. Med.

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The relationship between hospital caseload or volume and the outcome of various surgical procedures has been well documented. However, such hospital caseload-outcome relationship (HCOR) has been seldom addressed in rare medical conditions, such as pleural infection, which is usually associated with pneumonia and may progress to systemic inflammation and severe sepsis. Pleural infection can be treated with medical or surgical pleural space drainage, but the treatment is still unstandardized. This population-based study, using Taiwan's medical claim data, investigated the HCOR in patients with pleural infection. A total of 24,876 patients with pleural infection (median age of 65 years; men, 76.6%) were identified between 1997 and 2008. Hospital caseload was calculated with the average number of cases per hospital annually. The primary outcome is hospital mortality, and the secondary outcomes include hospital length of stay and charges. The risk of mortality among patients treated in hospitals with the highest caseload quartile (≥ 14 cases per hospital annually) is less than those treated in hospitals with the lowest caseload (1 case per hospital annually) by 27% (adjusted odds ratio = 0.73, 95% confidence interval = 0.55 to 0.96). Such beneficial effect disappeared after adjustment for therapeutic procedures. Hospital caseload explained only a small portion of variation in hospital mortality (−2 log likelihood % = 0.26%). These findings suggest that higher hospital caseload is associated with better outcomes of patients with pleural infection. The difference in therapeutic procedures for pleural infection contributes to the observed effect of hospital caseload on hospital mortality.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Higher Hospital Caseload Is Associated with Better Treatment Outcomes of Patients with Pleural Infection

Shen

2014

Tohoku J. Exp. Med.

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“…Rates of microbiological diagnosis in earlier studies have shown a wide variation. A lower positive culture rates similar to ours has been observed in Indian studies like that of Mohanty et al(15.3%) [14] and western studies like Ferrer et al(15.5%) [15] , Walshe et al(3.5%) [16]and Barnes et al(1.4%) [16].A high turnover rate of pleural fluid cultures varying from 31-89% have been reported by various workers across the world [2,13,14,[17][18][19][20][21][22][23][24][25]. A retrospective review done at Mayo medical centre, Rochester on the low yield of microbiological studies on pleural fluid specimens by Barnes et al including 1320 samples had a meagre 19 (1.4%) true positive results.…”

Section: Discussionmentioning

confidence: 99%

EMPYEMA THORACIS: Bacteriological analysis of pleural fluid from the largest chest hospital in Delhi

Jain¹

2013

IOSR-JDMS

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“…It is also possible that the patient had transient bacteremia due to his fever seemed to be improved with supportive care during admission day 2, but this is less likely because 37. Aerobic microbes are the most common cause of clinical infections such as community-acquired bacteremia and opportunistic infections, and aerobic bacteremia can be serious and even life-threatening in patients with weakened immune systems [19,20]. Chronic heavy drinking increases the risk of infection by disrupting the immune system [21][22][23].…”

Section: From 2004 To 2008 Human Blood Cultures Yielded Fourmentioning

confidence: 99%

First Case ofPsychrobacter sanguinisBacteremia in a Korean Patient

Lim

Lee

et al. 2017

Ann Clin Microbiol

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Psychrobacter sanguinis has been described as a Gram-negative, aerobic coccobacilli originally isolated from environments and seaweed samples. To date, 6 cases of P. sanguinis infection have been reported. A 53-year-old male was admitted with a generalized tonic seizure lasting for 1 minute with loss of consciousness and a mild fever of 37.8 o C. A Gram stain revealed Gram-negative, small, and coccobacillishaped bacteria on blood culture. Automated microbiology analyzer identification using the BD BACTEC FX (BD Diagnostics, Germany) and VITEK2 (bioMérieux, France) systems indicated the presence of Methylobacterium spp., Aeromonas salmonicida, and the Moraxella group with low discrimination. The GenBank Basic Local Alignment Search Tool and an Ez-Taxon database search revealed that the 16S rRNA gene sequence of the isolate showed 99.30% and 99.88% homology to 859 base-pairs of the corresponding sequences of P. sanguinis, respectively (GenBank accession numbers JX501674.1 and HM212667.1). To the best of our knowledge, this is the first human case of P. sanguinis bacteremia in Korea. It is notable that we identified a case based on blood specimens that previously had been misidentified by a commercially automated identification analyzer. We utilized 16S rRNA gene sequencing as a secondary method for correctly identifying this microorganism.

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An Urgent Problem of Aerobic Gram-Negative Pathogen Infection in Complicated Parapneumonic Effusions or Empyemas

Cited by 21 publications

References 16 publications

Higher Hospital Caseload Is Associated with Better Treatment Outcomes of Patients with Pleural Infection

Higher Hospital Caseload Is Associated with Better Treatment Outcomes of Patients with Pleural Infection

EMPYEMA THORACIS: Bacteriological analysis of pleural fluid from the largest chest hospital in Delhi

First Case ofPsychrobacter sanguinisBacteremia in a Korean Patient

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