呼吸道分泌物培养在细菌性脓胸手术预后预测中的作用。

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Chia-Chi Liu, Ya-Fu Cheng, Yi-Ling Chen, Ching-Yuan Cheng, Chang-Lun Huang, Wei-Heng Hung, Bing-Yen Wang
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引用次数: 0

摘要

目的:胸脓肿是一种严重的感染。电视胸腔镜手术是一种推荐的治疗方法,术中收集胸膜液和组织培养物。胸膜剥离组织培养和胸膜液培养的结合提高了阳性培养率。我们的目的是研究呼吸分泌物培养的作用,以确定改善手术结果的最佳管理方法。方法:该研究分析了225例接受胸腔镜下去皮术的II/III期胸脓肿成年患者。获得呼吸分泌物培养并与胸膜培养进行比较。主要结局是培养阳性和病原体一致性,次要结局包括重症监护病房住院时间、住院时间和死亡率。结果:225例胸膜积液培养阳性或胸膜剥离组织培养阳性的脓胸患者。其中76例患者住院期间呼吸道分泌物培养阳性。呼吸道分泌物培养中最常见的病原菌为铜绿假单胞菌(44%)和肺炎克雷伯菌(16%),胸膜培养中最常见的病原菌为链球菌(38%)和肺炎克雷伯菌(12%)。呼吸道分泌物培养和胸膜液/组织培养有共同病原菌30例。这些患者的预后指标较差,包括术前抗生素使用时间较长[2.50(1.00-6.00)天对5.00(2.75-11.00)天,p = 0.006],住院期间死亡率较高(40.0%对17.4%,p = 0.002)。结论:呼吸道分泌物培养对预测细菌性脓胸手术结果至关重要,及时采集标本可提高患者生存率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Role of respiratory secretion culture in the surgical outcome prediction of bacterial empyema.

Objectives: Thoracic empyema is a serious infection. Video-assisted thoracoscopic surgery is a recommended treatment, and pleural fluid and tissue cultures are collected intraoperatively. The combination of a pleural peels tissue culture and a pleural fluid culture improves the positive culture rate. We aimed to investigate the role of respiratory secretion cultures to determine the optimal management for improving surgical outcome.

Methods: The study analyzed 225 adult patients with phase II/III thoracic empyema who underwent thoracoscopic decortication. Respiratory secretion cultures were obtained and compared with pleural cultures. Key outcomes were culture positivity and pathogen consistency, with secondary outcomes including intensive care unit stay, hospital stay, and mortality.

Results: There were 225 empyema patients with either a positive pleural fluid culture or a positive pleural peel tissue culture. Of these, 76 patients had positive respiratory secretion culture findings during hospitalization. The most common pathogen species were Pseudomonas aeruginosa (44%) and Klebsiella pneumoniae (16%) in the respiratory secretion cultures and Streptococcus spp. (38%) and Klebsiella pneumoniae (12%) in the pleural cultures. There were 30 patients having a common pathogen in the respiratory secretion culture and in the pleural fluid/tissue culture. Poor outcome measures were found in these patients, including the longer use of antibiotics preoperatively [2.50 (1.00-6.00) days versus 5.00 (2.75-11.00) days, p = 0.006] and a higher mortality rate during hospitalization (40.0% versus 17.4%, p = 0.002).

Conclusions: Respiratory secretion cultures are vital for predicting surgical outcomes in bacterial empyema, and prompt specimen collection can improve patient survival.

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来源期刊
General Thoracic and Cardiovascular Surgery
General Thoracic and Cardiovascular Surgery Medicine-Pulmonary and Respiratory Medicine
CiteScore
2.70
自引率
8.30%
发文量
142
期刊介绍: The General Thoracic and Cardiovascular Surgery is the official publication of The Japanese Association for Thoracic Surgery and The Japanese Association for Chest Surgery, the affiliated journal of The Japanese Society for Cardiovascular Surgery, that publishes clinical and experimental studies in fields related to thoracic and cardiovascular surgery.
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