Clinical Characteristics and Outcome in Adult Patients with Pneumococcal Empyema

肺炎球菌導致之膿胸在成年病患的臨床特徵及預後

羅君禹(Chun-Yu Lo) ； 林恕民(Shu-Min Lin) ； 郭安靜(An-Jing Kuo) ； 鍾福財(Fu-Tsai Chung) ； 張博瑞(Po-Jui Chang) ； 郭志熙(Chih-Shia Kuo) ； 林鴻銓(Horng-Chyuan Lin) ； 郭漢彬(Han-Pin Kuo)

《胸腔醫學》 21卷5期 (2006/10) Pp. 413-421

https://doi.org/10.29806/TM.200610.0003

摘要

Background: Pneumococcus is the leading cause of pneumonia. However, little data exists concerning the clinical characteristics and risk factors associated with pneumococcal empyema, a common complication of pneumococcal pneumonia.
Patients and Methods: This study retrospectively reviewed the data of 20 adult patients with culture-proven pneumococcal empyema who were hospitalized at Chang Gung Memorial Hospital, Taipei, from November 1998 to May 2005. Baseline characteristics, underlying diseases, outcome parameter and antibiotic insusceptibility rates were analyzed. Additionally, outcome parameters for 2 groups-the community-acquired empyema (CAE) group (n=12) and the hospital-acquired empyema (HAE) group (n=8)-were compared.
Results: Patients with HAE had a higher pulse rate, higher pH value and lower PaO2 of arterial blood gas than the CAE patients (p=0.073, 0.024 and 0.055, respectively). Malignancy, which was the most common underlying disease for both groups, was more common in the HAE group (87.5%, n=8) than in the CAE group (33%, n=12) (p=0.017). The most common malignant diseases were lung, head, and neck cancer. Duration of parenteral antibiotics therapy, duration of fever, and duration of hospital stay were longer in the HAE group than in the CAE group (all p＜0.05, respectively). The antibiotic insusceptibility rates of penicillin, cefuroxime, ceftriaxone and vancomycin were not significantly different between the CAE and HAE group (all p＞0.2).
Conclusion: Patients with HAE had poorer outcomes than those with CAE. Underlying malignancies were a major risk factor for HAE.

關鍵字

肺炎球菌 ； 膿胸 ； 肋膜 ； 惡性腫瘤 ； 抗生素 ； 敏感性

並列摘要

Background: Pneumococcus is the leading cause of pneumonia. However, little data exists concerning the clinical characteristics and risk factors associated with pneumococcal empyema, a common complication of pneumococcal pneumonia.
Patients and Methods: This study retrospectively reviewed the data of 20 adult patients with culture-proven pneumococcal empyema who were hospitalized at Chang Gung Memorial Hospital, Taipei, from November 1998 to May 2005. Baseline characteristics, underlying diseases, outcome parameter and antibiotic insusceptibility rates were analyzed. Additionally, outcome parameters for 2 groups-the community-acquired empyema (CAE) group (n=12) and the hospital-acquired empyema (HAE) group (n=8)-were compared.
Results: Patients with HAE had a higher pulse rate, higher pH value and lower PaO2 of arterial blood gas than the CAE patients (p=0.073, 0.024 and 0.055, respectively). Malignancy, which was the most common underlying disease for both groups, was more common in the HAE group (87.5%, n=8) than in the CAE group (33%, n=12) (p=0.017). The most common malignant diseases were lung, head, and neck cancer. Duration of parenteral antibiotics therapy, duration of fever, and duration of hospital stay were longer in the HAE group than in the CAE group (all p＜0.05, respectively). The antibiotic insusceptibility rates of penicillin, cefuroxime, ceftriaxone and vancomycin were not significantly different between the CAE and HAE group (all p＞0.2).
Conclusion: Patients with HAE had poorer outcomes than those with CAE. Underlying malignancies were a major risk factor for HAE.

並列關鍵字

pneumococcal empyema ； pleural effusion ； malignancy ； antibiotics ； susceptibility