Pediatric empyema thoracis: What has changed over a decade?
In: Journal of Tropical Pediatrics, Jg. 65 (2019-06-01), Heft 3, S. 231-239
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Zugriff:
Objectives: The purposes of this paper are to study clinicobacteriological profile, treatment modalities and outcome of pediatric empyema thoracis and to identify changes over a decade. Design: This is a retrospective study. Setting: Department of Pediatrics of a tertiary care hospital in North India. Patients: We enrolled 205 patients (1 month-12 years) of empyema thoracis admitted over 5 years (2007-11) and compared the profile with that of a previous study from our institute (1989-98). Results: Pleural fluid cultures were positive in 40% (n = 82) cases from whom 87 isolates were obtained. Staphylococcus aureus was the most common isolate (66.7%). Methicillin-sensitive S. aureus accounted for 56%, Methicillin-resistant S. aureus (MRSA) 10% and gram-negative organisms 18.3% of isolates. Intercostal drainage tube (ICDT) was inserted in 97.5%, intrapleural streptokinase was administered in 33.6%, and decortication performed in 27.8% cases. Duration of hospital stay was 17.2 (±6.3) days, duration of antibiotic (intravenous and oral) administration was 23.8 (±7.2) days and mortality rate was 4%. In the index study (compared with a previous study), higher proportion of cases received parenteral antibiotics (51.7% vs. 23.4%) and ICDT insertion (20.5% vs. 7%) before referral and had disseminated disease (20.5% vs. 14%) and septic shock (11.2% vs. 1.6%), less culture positivity (40% vs. 48%), more MRSA (10.3% vs. 2.5%) and gram-negative organisms (18.4% vs. 11.6%), increased use of intrapleural streptokinase and surgical interventions (27.8% vs. 19.7%), shorter hospital stay (17 vs. 25 days) and higher mortality (3.9% vs. 1.6%). Conclusions: Over a decade, an increase in the incidence of empyema caused by MRSA has been noticed, with increased use of intrapleural streptokinase and higher number of surgical interventions. [ABSTRACT FROM AUTHOR]
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Titel: |
Pediatric empyema thoracis: What has changed over a decade?
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Autor/in / Beteiligte Person: | Angurana, Suresh Kumar ; Kumar, Rakesh ; Singh, Meenu ; Verma, Sanjay ; Samujh, Ram ; Singhi, Sunit |
Zeitschrift: | Journal of Tropical Pediatrics, Jg. 65 (2019-06-01), Heft 3, S. 231-239 |
Veröffentlichung: | 2019 |
Medientyp: | academicJournal |
ISSN: | 0142-6338 (print) |
DOI: | 10.1093/tropej/fmy040 |
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