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Sources of pathogens causing pleuropulmonary infections after lung cancer resection

M Sok1, A Z Dragas, J Erzen

  • 1Department of Thoracic Surgery, Division of Surgery, University Medical Centre Ljubljana, Zaloska 2, Ljubljana, Slovenia. miha.sok@mf.uni-lj.si

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|July 10, 2002
PubMed
Abstract

Insights

Postoperative lung infection pathogens are likely acquired from the patient's own upper airway. Postoperative sputum cultures strongly correlate with infection sources, aiding antibiotic prophylaxis in lung cancer surgery.

Area of Science:

  • Medical Microbiology
  • Thoracic Surgery
  • Infectious Diseases

Background:

  • The origin of pathogens causing pleuropulmonary complications post-lung resection remains unclear.
  • Identifying the source of infection is crucial for effective perioperative antibiotic strategies in lung cancer surgery.

Purpose of the Study:

  • To prospectively evaluate the diagnostic value of sputum samples and intraoperative bronchial swabs.
  • To identify the source of pathogens responsible for infective pulmonary complications after lung cancer resection.

Main Methods:

  • A prospective trial involving 194 lung cancer patients undergoing resection.
  • Collected sputum samples preoperatively and 3 days postoperatively.
  • Utilized intraoperative bronchial swabs and analyzed various postoperative fluids for pathogen identification.

Main Results:

  • Pleuropulmonary infections occurred in 34 patients; gram-negative bacteria and Candida albicans were common pathogens.
  • Postoperative sputum samples identified causative pathogens in 63% of cases, showing a strong correlation (P<0.01) with infection sources.
  • Preoperative sputum and intraoperative swabs had lower detection rates (18% and 13%) for these key pathogens.

Conclusions:

  • Pathogens causing post-lung resection pleuropulmonary infections are likely acquired from the patient's oral cavity, pharynx, and hypopharynx.
  • Postoperative sputum analysis is valuable for identifying pathogens and guiding antibiotic prophylaxis.

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