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Microbiological profile of tubercular and nontubercular empyemas and its impact on clinical outcomes: A retrospective analysis of 285 consecutively operated cases

BACKGROUND: Empyema thoracis is an entity seen across all age groups. This study aims at reporting a detailed microbiological profile of “pus and pleural tissue” in patients operated for empyema thoracis and also correlating it with perioperative clinical outcomes. MATERIALS AND METHODS: Patients op...

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Autores principales: Pulle, Mohan Venkatesh, Asaf, Belal Bin, Kumar, Arvind, Puri, Harsh Vardhan, Vijay, CL, Bishnoi, Sukhram
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7857372/
https://www.ncbi.nlm.nih.gov/pubmed/32883897
http://dx.doi.org/10.4103/lungindia.lungindia_553_19
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author Pulle, Mohan Venkatesh
Asaf, Belal Bin
Kumar, Arvind
Puri, Harsh Vardhan
Vijay, CL
Bishnoi, Sukhram
author_facet Pulle, Mohan Venkatesh
Asaf, Belal Bin
Kumar, Arvind
Puri, Harsh Vardhan
Vijay, CL
Bishnoi, Sukhram
author_sort Pulle, Mohan Venkatesh
collection PubMed
description BACKGROUND: Empyema thoracis is an entity seen across all age groups. This study aims at reporting a detailed microbiological profile of “pus and pleural tissue” in patients operated for empyema thoracis and also correlating it with perioperative clinical outcomes. MATERIALS AND METHODS: Patients operated for empyema thoracis between 2012 and 2016 were included in the study. Patients were taken up for surgery after thorough preoperative evaluation. Perioperative outcomes were correlated with the results of microbiological analysis to evaluate their effect on clinical outcomes. RESULTS: In the study, 285 patients were operated. There were 215 males (75.4%) and 70 females (24.6%). Tuberculosis (TB) was responsible for 58.2% of the cases (n = 166). Of 166, 32 patients were mycobacterial culture positive, suggesting 19.28% mycobacterial culture positivity rate. 21.8% of the total mycobacterial cultures were multidrug resistant. TB culture-positive patients had a significantly higher incidence of air leak (P = 0.03), inter-costal drain (ICD) duration (P = 0.03), and higher rates of recurrence (P = 0.03). Nontubercular empyema constituted 119 cases (41.8%). Forty-seven (39.5%) cases were culture positive. Gram-negative organisms were cultured in 30 (63.8%). Pseudomonas aeruginosa was the predominant isolate. Bacterial culture-positive patients had significantly higher conversions (P = 0.03), prolonged postoperative air leak (P = 0.04), and postoperative wound infections. CONCLUSIONS: This study highlights the emergence of Gram-negative organisms in bacterial empyema and emergence of multidrug resistance in tubercular empyema. Clinical outcome correlation revealed increased complications in culture-positive cases in both tubercular and nontubercular empyemas.
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spelling pubmed-78573722021-02-05 Microbiological profile of tubercular and nontubercular empyemas and its impact on clinical outcomes: A retrospective analysis of 285 consecutively operated cases Pulle, Mohan Venkatesh Asaf, Belal Bin Kumar, Arvind Puri, Harsh Vardhan Vijay, CL Bishnoi, Sukhram Lung India Original Article BACKGROUND: Empyema thoracis is an entity seen across all age groups. This study aims at reporting a detailed microbiological profile of “pus and pleural tissue” in patients operated for empyema thoracis and also correlating it with perioperative clinical outcomes. MATERIALS AND METHODS: Patients operated for empyema thoracis between 2012 and 2016 were included in the study. Patients were taken up for surgery after thorough preoperative evaluation. Perioperative outcomes were correlated with the results of microbiological analysis to evaluate their effect on clinical outcomes. RESULTS: In the study, 285 patients were operated. There were 215 males (75.4%) and 70 females (24.6%). Tuberculosis (TB) was responsible for 58.2% of the cases (n = 166). Of 166, 32 patients were mycobacterial culture positive, suggesting 19.28% mycobacterial culture positivity rate. 21.8% of the total mycobacterial cultures were multidrug resistant. TB culture-positive patients had a significantly higher incidence of air leak (P = 0.03), inter-costal drain (ICD) duration (P = 0.03), and higher rates of recurrence (P = 0.03). Nontubercular empyema constituted 119 cases (41.8%). Forty-seven (39.5%) cases were culture positive. Gram-negative organisms were cultured in 30 (63.8%). Pseudomonas aeruginosa was the predominant isolate. Bacterial culture-positive patients had significantly higher conversions (P = 0.03), prolonged postoperative air leak (P = 0.04), and postoperative wound infections. CONCLUSIONS: This study highlights the emergence of Gram-negative organisms in bacterial empyema and emergence of multidrug resistance in tubercular empyema. Clinical outcome correlation revealed increased complications in culture-positive cases in both tubercular and nontubercular empyemas. Wolters Kluwer - Medknow 2020 2020-08-31 /pmc/articles/PMC7857372/ /pubmed/32883897 http://dx.doi.org/10.4103/lungindia.lungindia_553_19 Text en Copyright: © 2020 Indian Chest Society http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Pulle, Mohan Venkatesh
Asaf, Belal Bin
Kumar, Arvind
Puri, Harsh Vardhan
Vijay, CL
Bishnoi, Sukhram
Microbiological profile of tubercular and nontubercular empyemas and its impact on clinical outcomes: A retrospective analysis of 285 consecutively operated cases
title Microbiological profile of tubercular and nontubercular empyemas and its impact on clinical outcomes: A retrospective analysis of 285 consecutively operated cases
title_full Microbiological profile of tubercular and nontubercular empyemas and its impact on clinical outcomes: A retrospective analysis of 285 consecutively operated cases
title_fullStr Microbiological profile of tubercular and nontubercular empyemas and its impact on clinical outcomes: A retrospective analysis of 285 consecutively operated cases
title_full_unstemmed Microbiological profile of tubercular and nontubercular empyemas and its impact on clinical outcomes: A retrospective analysis of 285 consecutively operated cases
title_short Microbiological profile of tubercular and nontubercular empyemas and its impact on clinical outcomes: A retrospective analysis of 285 consecutively operated cases
title_sort microbiological profile of tubercular and nontubercular empyemas and its impact on clinical outcomes: a retrospective analysis of 285 consecutively operated cases
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7857372/
https://www.ncbi.nlm.nih.gov/pubmed/32883897
http://dx.doi.org/10.4103/lungindia.lungindia_553_19
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