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Intensive Care Medicine

, Volume 32, Issue 4, pp 570–576 | Cite as

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

  • Chih-Yen Tu
  • Wu-Huei HsuEmail author
  • Te-Chun Hsia
  • Hung-Jen Chen
  • Kuo-Liang Chiu
  • Liang-Wen Hang
  • Chuen-Ming Shih
Original

Abstract

Objectives

To assess the incidence, pathogens, and outcome of complicated parapneumonic effusions or empyemas in a medical intensive care unit (MICU) patients with pleural effusions.

Design and setting

Prospective study of febrile MICU patients with pleural effusion carried out in a tertiary care hospital between April 2001 and September 2003.

Patients

The study included 175 patients with a temperature above 38° for more than 8 h with evidence of pleural effusion confirmed by chest radiography and ultrasound.

Intervention

Routine thoracentesis and effusion cultures.

Results

The prevalence of complicated parapneumonic effusions or thoracic empyemas in febrile MICU patients with pleural effusions was 45% (78/175). A total of 78 micro-organisms were isolated from the pleural fluid of 58 patients (positive microbiological culture 74%) including aerobic Gram-negative (n = 45), aerobic Gram-positive (n = 23), anaerobic (n = 5), Myobacterium tuberculosis (n = 3), and Candida (n = 2). The infection-related mortality rate of complicated parapneumonic effusions or empyemic patients in the MICU was 41% (32/78).

Conclusion

The development of complicated parapneumonic effusions or thoracic empyemas in MICU patients is a high-mortality disease. The increasing incidence of aerobic Gram-negative pathogens in empyema has become a more urgent problem.

Keywords

Bacteriology Complicated parapneumonic effusion Empyema Intensive care unit 

Supplementary material

134_2005_64_MOESM1_ESM.doc (456 kb)
Electronic Supplementary Material (DOC 456kb)

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Chih-Yen Tu
    • 1
  • Wu-Huei Hsu
    • 1
    Email author
  • Te-Chun Hsia
    • 1
  • Hung-Jen Chen
    • 1
  • Kuo-Liang Chiu
    • 1
  • Liang-Wen Hang
    • 1
  • Chuen-Ming Shih
    • 1
  1. 1.Division of Pulmonary and Critical Care Medicine, Department of Internal MedicineChina Medical University HospitalTaichungTaiwan

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