The bacteriology of pleural infection by genetic and standard methods and its mortality significance.
BACKGROUND: Antibiotic choices for pleural infection are uncertain as its bacteriology is poorly described. METHODS: Pleural fluid from 434 pleural infections underwent standard culture and a screen for bacteria by amplification and sequencing of bacterial 16S ribosomal RNA gene. RESULTS: Approximat...
| Main Authors: | , , , , , |
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| 格式: | Journal article |
| 語言: | English |
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2006
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| _version_ | 1826305128167112704 |
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| author | Maskell, N Batt, S Hedley, E Davies, C Gillespie, S Davies, R |
| author_facet | Maskell, N Batt, S Hedley, E Davies, C Gillespie, S Davies, R |
| author_sort | Maskell, N |
| collection | OXFORD |
| description | BACKGROUND: Antibiotic choices for pleural infection are uncertain as its bacteriology is poorly described. METHODS: Pleural fluid from 434 pleural infections underwent standard culture and a screen for bacteria by amplification and sequencing of bacterial 16S ribosomal RNA gene. RESULTS: Approximately 50% of community-acquired infections were streptococcal, and 20% included anaerobic bacteria. Approximately 60% of hospital-acquired infections included bacteria frequently resistant to antibiotics (methicillin-resistant Staphylococcus aureus, 25%; Enterobacteriaceae, 18%; Pseudomonas spp., 5%, enterococci, 12%). Mortality was increased in hospital-acquired infection (hospital, 17/36 [47%]; community, 53/304 [17%]; relative risk, 4.24; 95% confidence interval, 2.07-8.69; p < 0.00001; chi(2), 1 df = 17.47) and in gram-negative (10/22 [45%]), S. aureus (15/34 [44%]), or mixed aerobic infections (13/28 [46%]), compared with streptococcal infection (23/137 [17%]) and infection including anaerobic bacteria (10/49 [20%]; p < 0.00001, chi(2), 4 df = 23.35). CONCLUSION: Pleural infection differs bacteriologically from pneumonia and requires different treatment. Antibiotics for community-acquired infection should treat aerobic and anaerobic bacteria. Hospital-acquired, gram-negative S. aureus and mixed aerobic infections have a high mortality rate. |
| first_indexed | 2024-03-07T06:28:10Z |
| format | Journal article |
| id | oxford-uuid:f50ab8bf-e88f-41c4-80f8-4e01f1cf6397 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:28:10Z |
| publishDate | 2006 |
| record_format | dspace |
| spelling | oxford-uuid:f50ab8bf-e88f-41c4-80f8-4e01f1cf63972022-03-27T12:24:18ZThe bacteriology of pleural infection by genetic and standard methods and its mortality significance.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f50ab8bf-e88f-41c4-80f8-4e01f1cf6397EnglishSymplectic Elements at Oxford2006Maskell, NBatt, SHedley, EDavies, CGillespie, SDavies, RBACKGROUND: Antibiotic choices for pleural infection are uncertain as its bacteriology is poorly described. METHODS: Pleural fluid from 434 pleural infections underwent standard culture and a screen for bacteria by amplification and sequencing of bacterial 16S ribosomal RNA gene. RESULTS: Approximately 50% of community-acquired infections were streptococcal, and 20% included anaerobic bacteria. Approximately 60% of hospital-acquired infections included bacteria frequently resistant to antibiotics (methicillin-resistant Staphylococcus aureus, 25%; Enterobacteriaceae, 18%; Pseudomonas spp., 5%, enterococci, 12%). Mortality was increased in hospital-acquired infection (hospital, 17/36 [47%]; community, 53/304 [17%]; relative risk, 4.24; 95% confidence interval, 2.07-8.69; p < 0.00001; chi(2), 1 df = 17.47) and in gram-negative (10/22 [45%]), S. aureus (15/34 [44%]), or mixed aerobic infections (13/28 [46%]), compared with streptococcal infection (23/137 [17%]) and infection including anaerobic bacteria (10/49 [20%]; p < 0.00001, chi(2), 4 df = 23.35). CONCLUSION: Pleural infection differs bacteriologically from pneumonia and requires different treatment. Antibiotics for community-acquired infection should treat aerobic and anaerobic bacteria. Hospital-acquired, gram-negative S. aureus and mixed aerobic infections have a high mortality rate. |
| spellingShingle | Maskell, N Batt, S Hedley, E Davies, C Gillespie, S Davies, R The bacteriology of pleural infection by genetic and standard methods and its mortality significance. |
| title | The bacteriology of pleural infection by genetic and standard methods and its mortality significance. |
| title_full | The bacteriology of pleural infection by genetic and standard methods and its mortality significance. |
| title_fullStr | The bacteriology of pleural infection by genetic and standard methods and its mortality significance. |
| title_full_unstemmed | The bacteriology of pleural infection by genetic and standard methods and its mortality significance. |
| title_short | The bacteriology of pleural infection by genetic and standard methods and its mortality significance. |
| title_sort | bacteriology of pleural infection by genetic and standard methods and its mortality significance |
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