Empyema occurring in the multiply traumatized patient

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Thoracic Surgery

Background:

• Nosocomial empyema is a serious complication in multiply traumatized patients.
• Identifying risk factors and pathogens is essential for effective treatment.

Purpose of the Study:

• To investigate the incidence, risk factors, and causative pathogens of nosocomial empyema in multiply traumatized patients.

Main Methods:

• Retrospective analysis of 741 multiply traumatized patients over 11 months.
• Definition of nosocomial empyema: purulent, culture-positive pleural fluid after 5 days of hospitalization.
• Identification of pathogens and assessment of risk factors.

Main Results:

• 31 cases of nosocomial empyema identified in 29 patients.
• Common pathogens included Staphylococcus aureus and Gram-negative bacilli.
• Chest tube insertion for pleural fluid was a significant risk factor, with 16% developing empyema.
• Empyema following hemothorax was often S. aureus; following pneumothorax/serothorax, it was Gram-negative.

Conclusions:

• Nosocomial empyema is a significant concern in multiply traumatized patients, particularly those with chest tubes.
• Causative pathogens and timing of empyema onset vary depending on the initial pleural condition.
• Further research into preventative strategies and early diagnostic markers is warranted.