RT Journal Article
SR Electronic
T1 Bacterial aetiology in the Danish pleural empyema project
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P1743
VO 40
IS Suppl 56
A1 Christian N. Meyer
A1 Karin Armbruster
A1 Bo Broberg
A1 Alice Friis-Moller
A1 Ram D. Dessau
A1 Ina S. Petersen
A1 Michael Pedersen
A1 Thomas Ringbæk
A1 Michael Kemp
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P1743.abstract
AB Recent publications identified the aetiology of pleural empyema with results varying according to antimicrobials given before sampling.ObjectivesOur aim was to identify the microbiological aetiology in pleural empyema by standard methods and later evaluate, if DNA-amplification methods may supplement culture results by detecting further clinically relevant micro-organisms.MethodsFrom 2008-2011 in the Danish Pleural Empyema Project, the respiratory medical departments from 8 Danish hospitals participated. Cases were prospectively identified clinically and pleural fluid samples were collected for standard microbiological analysis (microscopy and culture). Further samples were collected and kept in storage at minus 80 degrees Celsius for later PCR analyses. Cases judged as non-infectious were excluded. Clinical data were collected regarding symptoms, pre-admission treatment, clinical findings, risk factors, co-morbidity, blood test results, radiology, treatment, and outcome.ResultsA total of 434 episodes of pleural empyema were identified. In 242 cases (56%), the cultures were either negative (n=198) or no pleural samples were successfully taken (n=44). Among the 192 cases with proven aetiology, mixed infections were identified in 47 cases (24%), 34 Streptococcus pneumoniae (18%), 53 non-pneumoniae streptococci (28%), 16 Staphylococcus aureus (8.3%), 15 enterobacteriaceae (7.8%), 15 anaerobes (7.8%), and 5 Enterococcus species (2.6%).Conclusions. 56% of the cases were culture negative by standard methods. Future studies are planned to implement DNA-methods optimised for mixed infections for identification of the micro-organisms. This may expand the identified spectrum of detected micro-organisms and improve the treatment.