Document Type : Original Research
Dept. of Pathology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
evelopment Association for Clinical Study (DACS), Student Scientific Research Center (SSCR), Tehran University of Medical Sciences, Tehran, Iran
Background and Objectives:Infection of pleural fluid is a common disease and because of antibiotic administration, the microbiology of this fluid has changed. The aim of this study was to determine the common bacteria and suitable antibiotics for treatment in pleural effusion (PE).
Materials and Methods: In this cross sectional study, 1210 samples with exudative features were cultured for possible growth of microbial pathogens and then examined for antibiotics sensitivity. Samples’ characteristics were then analyzed according to the age and sex difference.
Results: Among 1210 exudative pleural effusions, 38.2% were obtained from females and 61.8% from males. Of 142 pleural fluid samples, 11.7% had a positive culture. Aerobic gram negative organism was the most common type among the other samples with a prevalence of 52% followed by aerobic gram positive (25.3%), non- aerobic gram negative (15.7%), non- aerobic gram positive (6.2%) and fungi (0.8%). E. coli, Staphylococcus Aureus and Acinetobacter baumannii were the most common types of organism among adult population.
Conclusion:Aerobic gram positive bacteria had the highest prevalence among the pathogens, and cephalosporins, aminopenicillins and β-lactams were the most effective antibiotics for their treatment.
- Light RW, Macgregor MI, Luchsinger PC, Ball WCJ. Pleural effusions: the diagnostic separation of transudates and exudates. Ann Intern Med 1972;77:507-13.
- Antony VB, Godbey SW, Kunkel SL, Hott JW, Hartman DL, Burdick MD, et al. Recruitment of inﬂammatory cells to the pleural space: chemotactic cytokines, IL-8, and monocyte chemotactic peptide-1 in human pleural ﬂuids. J Immunol 1993;151:7216-23.
- Sahn SA. State of the art: the pleura. Am Rev Respir Dis 1988;138:184-234.
- Light RW. Pleural Diseases. Philadelphia: Lea and Febiger;1983.
- Ahmed RA, Marrie TJ, Huang JQ. Thoracic empyema in patients with community-acquired pneumonia. Am J Med 2006;119(10):877-83.
- Maskell NA, Batt S, Hedley EL, Davies CW, Gillespie SH, Davies RJ, et al. The bacteriology of pleural infection by genetic and standard methods and its mortality signiﬁcance. Am J Respir Crit Care Med 2006;174:817-24.
- Rahman NM, Chapman SJ, Davies RJO. The approach to the patient with a parapneumonic effusion. Clin Chest Med 2006;27:253-66.
- Schiza S, Siafakas NM. Clinical presentation and management of empyema, lung abscess and pleural effusion.Curr Opin Pulm Med 2006;12(3):205-11.
- Schultz KD, Fan LL, Pinsky J, Ochoa L, Smith EO, Kaplan SL, et al. The changing face of pleural empyemas in children: epidemiology and management. Pediatrics 2004;113:1735-40.
- Ozol D, Oktem S, Erdinc E. Complicated parapneumonic effusion and empyema thoracis: microbiologic and therapeutic aspects. Respir Med 2006;100:286-91.
- Jiménez D, Díaz G, García-Rull S, Vidal R, Sueiro A, Light RW. Routine use of pleural ﬂuid cultures. Are they indicated? Limited yield, minimal impact on treatment decisions. Respir Med 2006;100:2048-52.
- Storm HK, Krasnik M, Bang K, Frimodt-Møller N. Treatment of pleural empyema secondary to pneumonia: thoracocentesis regimen versus tube drainage Thorax 1992;47:821-4.
- Ashbaugh DG. Empyema thoracis. Factors influencing morbidity and mortality. Chest 1991;99:1162-5.
- Maskell NA, Davies CW, Jones E, Davies RJ. The characteristics of 300 patients partcipating in the MRC/BTS multicentre intra-pleural streptokinase vs. placebo trial (ISRCTN-39138989) Presented at the American Thoracic Society Meeting, Atlanta, GA, 2002.
- Bartlett JG. Antibiotics in lung abscess. Semin Respir Infect 1991;6:103-11.
- Davies CW, Gleeson FV, Davies RJ. BTS guidelines for the management of pleural infection. Thorax2003;58(2):ii18-28.
Davies CWH, Gleeson FV, Davies RJO. Pleural Diseases Group, Standards of Care Committee. British Thoracic Society. BTS guidelines for the management of pleural infection. Thorax 2003;58(II):ii18-28.
- Hughes CE, Van Scoy RE. Antibiotic therapy of pleural empyema. Semin Respir Infect
- Hammami S, Saidani M, Ferjeni S, Aissa I, Slim A, Boutiba-Ben Boubaker I. Characterization of Extended Spectramase-Producing Escherichia coli in Community-Acquired Urinary Tract Infections in Tunisia. Microb Drug Resist. 2013 Jan 30. [In Press]