PDF(Pubmed)
Abstract：
UNASSIGNED: The clinical significance of bacteremia in patients with complicated pleural infection is still uncertain. We aimed to examine the incidence and clinical significance of bacteremia in patients with complicated pleural infection.
UNASSIGNED: This retrospective study comprised of consecutive patients who received pleural drainage due to complicated parapneumonic effusion or empyema. The clinical, laboratory, and radiologic data and clinical outcome were compared between patients with and without bacteremia. Additionally, the factors associated with overall mortality were evaluated in these patients.
UNASSIGNED: Of 341 patients included in the analysis, 25 (7 %) had a positive blood culture. Blood culture testing added 2 % identification of causative pathogen compared to pleural fluid culture alone. By multivariable analysis, radiologic features of cavitary lesion, a RAPID score≥5, and a positive microbial culture in pleural fluid were independently associated with bacteremia. Despite these clinical distinctions, there was ultimately no significant difference in in-hospital mortality between patients with and without bacteremia (3 vs. 4 %, p=1.0). The only factor significantly associated with overall mortality among patients with complicated pleural infections was a higher RAPID score [HR=1.96 (95 % CI=1.35-2.84)].
UNASSIGNED: The rate of bacteremia in patients with complicated pleural infection was 7 %. Blood culture testing demonstrated limited diagnostic yield and had minimal impact on clinical outcomes compared to pleural fluid culture. Therefore, it seems that blood culture testing is more advantageous for specific patients with suspected pleural infection who have cavitary lesions or a RAPID score≥5.
UNASSIGNED: This retrospective study comprised of consecutive patients who received pleural drainage due to complicated parapneumonic effusion or empyema. The clinical, laboratory, and radiologic data and clinical outcome were compared between patients with and without bacteremia. Additionally, the factors associated with overall mortality were evaluated in these patients.
UNASSIGNED: Of 341 patients included in the analysis, 25 (7 %) had a positive blood culture. Blood culture testing added 2 % identification of causative pathogen compared to pleural fluid culture alone. By multivariable analysis, radiologic features of cavitary lesion, a RAPID score≥5, and a positive microbial culture in pleural fluid were independently associated with bacteremia. Despite these clinical distinctions, there was ultimately no significant difference in in-hospital mortality between patients with and without bacteremia (3 vs. 4 %, p=1.0). The only factor significantly associated with overall mortality among patients with complicated pleural infections was a higher RAPID score [HR=1.96 (95 % CI=1.35-2.84)].
UNASSIGNED: The rate of bacteremia in patients with complicated pleural infection was 7 %. Blood culture testing demonstrated limited diagnostic yield and had minimal impact on clinical outcomes compared to pleural fluid culture. Therefore, it seems that blood culture testing is more advantageous for specific patients with suspected pleural infection who have cavitary lesions or a RAPID score≥5.
摘要：
■复杂胸膜感染患者菌血症的临床意义尚不确定。我们旨在研究复杂胸膜感染患者菌血症的发生率和临床意义。
■这项回顾性研究包括因复杂的肺炎旁积液或脓胸而接受胸腔引流的连续患者。临床，实验室,比较有和无菌血症患者的放射学数据和临床结局.此外,在这些患者中评估了与总死亡率相关的因素.
■在分析中纳入的341名患者中，25例(7%)血培养阳性。与单独的胸膜液培养相比，血液培养测试增加了2％的病原体鉴定。通过多变量分析，空洞性病变的放射学特征，RAPID评分≥5分和胸腔积液微生物培养阳性与菌血症独立相关.尽管有这些临床上的区别,有和没有菌血症的患者之间的住院死亡率最终没有显着差异(3vs.4%,p=1.0)。复杂胸膜感染患者中与总死亡率显著相关的唯一因素是较高的RAPID评分[HR=1.96(95%CI=1.35-2.84)]。
■并发胸膜感染患者菌血症发生率为7%。与胸膜液培养相比，血培养测试显示诊断产量有限，对临床结果的影响最小。因此,对于有空洞性病变或RAPID评分≥5分的疑似胸膜感染的特定患者,血培养检测似乎更有利.
■这项回顾性研究包括因复杂的肺炎旁积液或脓胸而接受胸腔引流的连续患者。临床，实验室,比较有和无菌血症患者的放射学数据和临床结局.此外,在这些患者中评估了与总死亡率相关的因素.
■在分析中纳入的341名患者中，25例(7%)血培养阳性。与单独的胸膜液培养相比，血液培养测试增加了2％的病原体鉴定。通过多变量分析，空洞性病变的放射学特征，RAPID评分≥5分和胸腔积液微生物培养阳性与菌血症独立相关.尽管有这些临床上的区别,有和没有菌血症的患者之间的住院死亡率最终没有显着差异(3vs.4%,p=1.0)。复杂胸膜感染患者中与总死亡率显著相关的唯一因素是较高的RAPID评分[HR=1.96(95%CI=1.35-2.84)]。
■并发胸膜感染患者菌血症发生率为7%。与胸膜液培养相比，血培养测试显示诊断产量有限，对临床结果的影响最小。因此,对于有空洞性病变或RAPID评分≥5分的疑似胸膜感染的特定患者,血培养检测似乎更有利.
