The Importance of Obligate Anaerobes and the &lt;b&gt;&lt;i&gt;Streptococcus anginosus&lt;/i&gt;&lt;/b&gt; Group in Pulmonary Abscess: A Clone Library Analysis Using Bronchoalveolar Lavage Fluid

Mukae, Hiroshi; Noguchi, Shingo; Naito, Keisuke; Kawanami, Toshinori; Yamasaki, Kei; Fukuda, Kazumasa; Akata, Kentaro; Fukuda, Yuichi; Kido, Takashi; Ishimoto, Hiroshi; Sakamoto, Noriho; Taniguchi, Hatsumi; Yatera, Kazuhiro

doi:10.1159/000447976

Cited by 37 publications

(40 citation statements)

References 22 publications

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“…In 4 patients (27%), attempts to culture the causative organism were not successful in sputum, bronchoalveolar lavage, and/or abscess aspirate. This negative culture rate is consistent with previous reports [10,11] and may potentially be improved using molecular bacterial detection methods [11] .…”

Section: Discussionsupporting

confidence: 92%

Bronchoscopic Drainage of Lung Abscesses Using a Pigtail Catheter

Unterman

Fruchter²,

Rosengarten³

et al. 2016

Respiration

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Background: Lung abscesses are commonly treated with antibiotics. However, some patients fail to respond and may require percutaneous catheter drainage or surgical intervention. Bronchoscopic drainage (BD) of lung abscesses emerged as a therapeutic alternative in selected patients. Objective: To describe our experience with 15 patients who underwent BD at our center during 2006-2016. Methods: Patients underwent flexible bronchoscopy. Under fluoroscopic guidance, a pigtail catheter was introduced into the abscess cavity, its correct position being confirmed by the injection of contrast medium. The catheter remained in place for a few days and was flushed repeatedly with antibiotics. Results: Fifteen patients (9 males; median age 59 years) underwent 16 BD procedures. A pigtail catheter was successfully inserted and pus was drained from the abscess cavity in 13 procedures (81%) conducted in 12 patients, leading to rapid clinical improvement in 10 of them; resolution of fever occurred a median of 2 days (range <1-4) following pigtail insertion, and patients were discharged after 8 days (range 4-21). The pigtail catheter was extracted after a median of 4 days (range 2-6). Conclusion: BD of lung abscesses was achieved in 13 out of 16 procedures, leading to rapid improvement in the majority of patients. This work adds to the existing literature in establishing this procedure as an acceptable therapeutic alternative in selected patients who fail to respond to antibiotics, especially those with an airway obstruction or a fairly central lung abscess.

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Section: Discussionsupporting

confidence: 92%

Bronchoscopic Drainage of Lung Abscesses Using a Pigtail Catheter

Unterman

Fruchter²,

Rosengarten³

et al. 2016

Respiration

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“…In addition, SAG phylotypes were especially predominant in elderly patients and patients with low serum albumin levels, compared to patients where other bacteria and/or obligate anaerobes were the most predominant phylotypes in the study. These findings are similar to our previous report on lung abscesses . In addition, our previous report also showed that aspiration of oral secretions might be a risk factor of empyema formation by SAG bacteria, similar to another report showing the importance of aspiration in developing pleural‐thoracic empyema .…”

Section: Discussionsupporting

confidence: 92%

“…13 Additionally, in our previous study investigating the clinical characteristics of patients with lung abscesses, the three defined groups of SAG, obligate anaerobes and other bacteria presented different clinical characteristics to each other. 17 However, there have been no reports so far on the clinical characteristics among these three groups in patients with bacterial pleuritis using molecular methods.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of patients with bacterial pleuritis in the presence of Streptococcus anginosus group and obligate anaerobes detected by clone library analysis

Hata

Kawanami

Noguchi

et al. 2019

Clinical Respiratory J

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Introduction Bacterial pleuritis is one of the most important pleural and respiratory infectious diseases, in addition, there have been no reports describing the clinical characteristics of patients with bacterial pleuritis according to molecular methods. An accurate understanding of the clinical characteristics and etiology of bacterial pleuritis is an issue that must be addressed. Objectives The aim of this study was to clarify the clinical characteristics of the bacterial species in bacterial pleuritis. Methods Pleural effusion samples were obtained from 29 patients with bacterial pleuritis. The microbiota of pleural effusion samples was analyzed by clone library analysis using the 16S ribosomal RNA gene. Results The phylotypes of Fusobacterium spp. (24.1%) were most frequently the predominant phylotypes, followed by those of Streptococcus anginosus group (SAG) (20.7%) and S. aureus (17.2%). The predominant phylotypes of obligate anaerobes, including the Fusobacterium spp., were detected in 11 of 29 patients (37.9%). Patients in the SAG group were significantly older and presented lower serum albumin levels than those in the obligate anaerobe and other bacterial groups. Patients from the obligate anaerobe group took longer to present symptoms, and therefore the diagnosis of pleuritis was also delayed, in comparison to patients in the other bacterial groups. Conclusions Our results demonstrated that there were characteristic differences between patients in SAG, obligate anaerobe and other bacterial groups. Physicians may need to consider treatment strategy options based on the clinical characteristics of patients with bacterial pleuritis.

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“…We defined the “mono-bacteria” group as patients in whom the predominant phylotype comprised >80% of the detected bacterial phylotypes using the clone library method; the remaining patients were categorized as the “mixed-bacteria” group 8,13,26. In the mixed-bacteria group, bacterial phylotypes that occupied >5% of the sample and the three most frequent bacterial phylotypes in each sample were evaluated.…”

Section: Methodsmentioning

confidence: 99%

Bacteriological incidence in pneumonia patients with pulmonary emphysema: a bacterial floral analysis using the 16S ribosomal RNA gene in bronchoalveolar lavage fluid

Naito¹,

Yamasaki²,

Yatera³

et al. 2017

COPD

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Pulmonary emphysema is an important radiological finding in chronic obstructive pulmonary disease patients, but bacteriological differences in pneumonia patients according to the severity of emphysematous changes have not been reported. Therefore, we evaluated the bacteriological incidence in the bronchoalveolar lavage fluid (BALF) of pneumonia patients using cultivation and a culture-independent molecular method. Japanese patients with community-acquired pneumonia (83) and healthcare-associated pneumonia (94) between April 2010 and February 2014 were evaluated. The BALF obtained from pneumonia lesions was evaluated by both cultivation and a molecular method. In the molecular method, ~600 base pairs of bacterial 16S ribosomal RNA genes in the BALF were amplified by polymerase chain reaction, and clone libraries were constructed. The nucleotide sequences of 96 randomly selected colonies were determined, and a homology search was performed to identify the bacterial species. A qualitative radiological evaluation of pulmonary emphysema based on chest computed tomography (CT) images was performed using the Goddard classification. The severity of pulmonary emphysema based on the Goddard classification was none in 47.4% (84/177), mild in 36.2% (64/177), moderate in 10.2% (18/177), and severe in 6.2% (11/177). Using the culture-independent molecular method, Moraxella catarrhalis was significantly more frequently detected in moderate or severe emphysema patients than in patients with no or mild emphysematous changes. The detection rates of Haemophilus influenzae and Pseudomonas aeruginosa were unrelated to the severity of pulmonary emphysematous changes, and Streptococcus species – except for the S. anginosus group and S. pneumoniae – were detected more frequently using the molecular method we used for the BALF of patients with pneumonia than using culture methods. Our findings suggest that M. catarrhalis is more frequently detected in pneumonia patients with moderate or severe emphysema than in those with no or mild emphysematous changes on chest CT. M. catarrhalis may play a major role in patients with pneumonia complicating severe pulmonary emphysema.

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The Importance of Obligate Anaerobes and the <b><i>Streptococcus anginosus</i></b> Group in Pulmonary Abscess: A Clone Library Analysis Using Bronchoalveolar Lavage Fluid

Cited by 37 publications

References 22 publications

Bronchoscopic Drainage of Lung Abscesses Using a Pigtail Catheter

Bronchoscopic Drainage of Lung Abscesses Using a Pigtail Catheter

Clinical characteristics of patients with bacterial pleuritis in the presence of Streptococcus anginosus group and obligate anaerobes detected by clone library analysis

Bacteriological incidence in pneumonia patients with pulmonary emphysema: a bacterial floral analysis using the 16S ribosomal RNA gene in bronchoalveolar lavage fluid

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