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Pediatric empyema thoracis: What has changed over a decade?
Suresh Kumar Angurana1, Rakesh Kumar1, Meenu Singh1
1Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Journal of Tropical Pediatrics
|July 28, 2018
Summary
Pediatric empyema thoracis shows an increasing incidence of Methicillin-resistant Staphylococcus aureus (MRSA) over a decade. This trend is associated with greater use of intrapleural streptokinase and more surgical interventions, alongside a higher mortality rate.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Thoracic Surgery
Background:
- Empyema thoracis is a significant cause of pediatric respiratory morbidity.
- Understanding clinicobacteriological profiles and treatment outcomes is crucial for improving patient care.
- Changes in causative organisms and treatment strategies necessitate updated clinical guidelines.
Purpose of the Study:
- To investigate the clinicobacteriological profile of pediatric empyema thoracis.
- To analyze treatment modalities and patient outcomes.
- To identify epidemiological and clinical changes over a ten-year period.
Main Methods:
- Retrospective study design.
- Inclusion of 205 pediatric patients (1 month-12 years) with empyema thoracis.
- Comparison of data from 2007-2011 with a previous study (1989-1998).
Main Results:
- Staphylococcus aureus was the most common pathogen (66.7%), with a notable increase in Methicillin-resistant S. aureus (MRSA) (10.3% vs. 2.5%).
- Higher rates of disseminated disease and septic shock were observed in the recent cohort.
- Increased utilization of intrapleural streptokinase and surgical interventions (decortication) was evident.
Conclusions:
- A decade has seen a rise in pediatric empyema cases attributed to MRSA.
- Treatment trends indicate increased use of intrapleural streptokinase and surgical interventions.
- The study highlights evolving challenges in pediatric empyema management, including higher mortality rates.
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