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The changing pathogens of complicated parapneumonic effusions or empyemas in a medical intensive care unit

Chih-Yen Tu1, Wu-Huei Hsu, Te-Chun Hsia

  • 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.

Intensive Care Medicine
|February 16, 2006
PubMed
Abstract

Insights

Complicated parapneumonic effusions and empyemas in medical intensive care unit (MICU) patients are common, with Gram-negative bacteria increasingly prevalent. This high-mortality disease requires urgent attention.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Complicated parapneumonic effusions and empyemas are serious pleural space infections.
  • These conditions pose significant challenges in medical intensive care units (MICUs).

Purpose of the Study:

  • To determine the incidence, causative pathogens, and outcomes of complicated parapneumonic effusions or empyemas in MICU patients.
  • To identify trends in microbial pathogens associated with these infections.

Main Methods:

  • A prospective study was conducted in a tertiary care hospital from April 2001 to September 2003.
  • 175 febrile MICU patients with pleural effusion (confirmed by radiography and ultrasound) underwent thoracentesis and effusion cultures.

Main Results:

  • The prevalence of complicated parapneumonic effusions or empyemas was 45% (78/175 patients).
  • Aerobic Gram-negative pathogens were the most common (n=45), followed by Gram-positive (n=23) and other organisms.
  • The infection-related mortality rate was high at 41% (32/78).

Conclusions:

  • Complicated parapneumonic effusions and empyemas represent a high-mortality condition in MICU patients.
  • There is a concerning increase in aerobic Gram-negative pathogens causing empyema, necessitating focused clinical and research efforts.

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