Background
Methods
Study design and patients
Diagnostic criteria
Microbiological evaluation
Statistical analysis
Results
Patient characteristics and laboratory findings of 30 patients
Total (n = 30) | |
---|---|
Age (y); mean ± SD | 68.9 ± 14.2 |
Gender (male/female) | 22/8 |
BMI; mean ± SD | 20.1 ± 4.1 |
Comorbidity diseases | 28 (93.3) |
Neoplastic disease | 8 (26.7) |
Cerebrovascular disease | 12 (40.0) |
Chronic pulmonary disease | 3 (10.0) |
Chronic cardiac disease | 4 (13.3) |
Chronic liver disease | 3 (10.0) |
Chronic renal disease | 4 (13.3) |
Diabetes mellitus | 6 (20.0) |
Smoking history | 13 (43.3) |
Alcohol | 8 (26.7) |
The days from symptom onset to consultation (days) | 15.1 ± 18.1 |
Symptoms at presentation | |
Fever | 24 (80.0) |
Cough | 14 (46.7) |
Sputum | 14 (46.7) |
Blood sputum | 2 (6.7) |
Chest pain | 14 (46.7) |
Disturbance of consciousness | 3 (10.0) |
Previous antibiotic treatment | 8 (26.7) |
Clinical parameter | |
Body temperature (°C) | 37.8 ± 0.7 |
Systolic blood pressure (mmHg) | 118.8 ± 20.9 |
Heart rate (beats/min) | 103.7 ± 17.0 |
Respiratory rate (/min) | 23.3 ± 5.7 |
Hypoxia (SpO2 ≤ 90 %) | 18 (60.0) |
Laboratory findings | |
White blood cell counts (/μL) | 17,627 ± 10,008 |
C-reactive protein (mg/dL) | 18.0 ± 11.1 |
Albumin (g/dL) | 2.5 ± 0.6 |
Pleural effusion | 22 (73.3) |
Complicated pleural effusion | 10 (33.3) |
Empyema | 11 (36.7) |
Cultured bacteria | |
SAG only | 24 (80.0) |
Mixed infection | 6 (20.0) |
Pneumonia severity index | 120.8 ± 42.2 |
Antibiotic treatment | |
Monotherapy | 25 (83.3) |
Penicillin/beta-lactamase inhibitors | 3 (10.0) |
Carbapenem | 19 (63.3) |
Linezolid | 1 (3.3) |
Macrolide | 2 (6.7) |
Combination therapy | 5 (16.7) |
3th-cephem + Macrolide | 1 (3.3) |
4th-cephem + Clindamycin | 1 (3.3) |
Carbapenem + Clindamycin | 2 (6.7) |
Fluoroquinolone + Clindamycin | 1 (3.3) |
Additional treatment | |
Only drainage | 5 (16.7) |
Drainage + lung decortication | 14 (46.7) |
Length of stay (days) | 27.7 ± 18.8 |
ICU admission | 6 (20.0) |
In-hospital mortality | 2 (6.7) |
Clinical outcomes
Microbiology
Cultured bacteria | No (%) |
---|---|
S. intermedius
| 16 (53.3) |
S. intermedius only | 14 (46.7) |
S. intermedius + H. influenzae
| 1 (3.3) |
S. intermedius + Fusobacterium spp. | 1 (3.3) |
S. constellatus
| 11 (36.7) |
S. constellatus only | 8 (26.7) |
S. constellatus + E. coli
| 1 (3.3) |
S. constellatus + K. pneumoniae
| 1 (3.3) |
S. constellatus + Bacteroides spp. + Peptostreptococcus spp. | 1 (3.3) |
S. anginosus
| 3 (10.0) |
S. anginosus only | 2 (6.7) |
S. anginosus + Bacteroides spp. | 1 (3.3) |
The clinical features, laboratory features, treatment, and outcomes among the patients with single infections
Total | Pneumonia | Lung abscess | Bacterial pleurisy only |
p-Value | |
---|---|---|---|---|---|
(n = 24) | (n = 16) | (n = 5) | (n = 3) | ||
Age (y); mean ± SD | 72.1 ± 11.6 | 74.8 ± 9.8 | 68.0 ± 15.4 | 65.0 ± 9.8 | NS |
Gender (male/female) | 18/6 | 11/5 | 5/0 | 2/1 | NS |
BMI; mean ± SD | 20.3 ± 4.4 | 19.6 ± 4.6 | 25.0 ± 3.5 | 19.6 ± 2.2 |
p = 0.032**
|
Comorbidity diseases | 23 (95.8) | 16 (100) | 4 (80.0) | 3 (100) | NS |
Neoplastic disease | 7 (29.2) | 4 (25.0) | 2 (40.0) | 1 (33.3) | NS |
Cerebrovascular disease | 9 (37.5) | 7 (43.8) | 1 (20.0) | 1 (33.3) | NS |
Chronic pulmonary disease | 2 (8.3) | 1 (6.3) | 1 (20.0) | 0 (0.0) | NS |
Chronic cardiac disease | 4 (16.7) | 4 (25.0) | 0 (0.0) | 0 (0.0) | NS |
Chronic liver disease | 3 (12.5) | 3 (18.8) | 0 (0.0) | 0 (0.0) | NS |
Chronic renal disease | 4 (16.7) | 2 (12.5) | 0 (0.0) | 2 (66.7) | NS |
Diabetes mellitus | 6 (25.0) | 4 (25.0) | 0 (0.0) | 2 (66.7) | NS |
Smoking history | 10 (41.7) | 7 (43.8) | 3 (60.0) | 0 (0.0) | NS |
Alcohol | 6 (25.0) | 5 (31.3) | 1 (20.0) | 0 (0.0) | NS |
The days from symptom onset to consultation (days) | 16.0 ± 19.6 | 9.0 ± 9.3 | 38.6 ± 30.8 | 16.0 ± 14.8 |
p = 0.031*
|
Symptoms at presentation | |||||
Fever | 19 (79.2) | 13 (81.3) | 4 (80.0) | 2 (66.7) | NS |
Cough | 12 (50.0) | 7 (43.8) | 4 (80.0) | 1 (33.3) | NS |
Sputum | 12 (50.0) | 7 (43.8) | 4 (80.0) | 1 (33.3) | NS |
Blood sputum | 2 (8.3) | 0 (0.0) | 1 (20.0) | 1 (33.3) | NS |
Chest pain | 12 (50.0) | 9 (56.3) | 1 (20.0) | 2 (66.7) | NS |
Disturbance of consciousness | 3 (12.5) | 3 (18.8) | 0 (0.0) | 0 (0.0) | NS |
Previous antibiotic treatment | 7 (29.2) | 6 (37.5) | 0 (0.0) | 1 (33.3) | NS |
Clinical parameter | |||||
Body temperature (°C) | 37.8 ± 0.80 | 37.9 ± 0.81 | 37.5 ± 0.97 | 37.8 ± 0.59 | NS |
Systolic blood pressure (mmHg) | 120.0 ± 22.2 | 117.8 ± 22.4 | 116.4 ± 19.3 | 135.3 ± 27.2 | NS |
Heart rate (beats/min) | 100.6 ± 15.1 | 102.7 ± 16.7 | 93.6 ± 13.4 | 101.0 ± 3.6 | NS |
Respiratory rate (/min) | 23.5 ± 6.1 | 25.0 ± 5.5 | 17.3 ± 5.1 | 27.0 ± 4.2 |
p = 0.029*
|
Hypoxia (SpO2 ≤ 90 %) | 15 (62.5) | 12 (75.0) | 1 (20.0) | 2 (66.7) |
p = 0.047*
|
Laboratory findings | |||||
White blood cell counts (/μL) | 16,763 ± 9412 | 18,869 ± 9532 | 10,080 ± 2906 | 16,667 ± 13,164 |
p = 0.014*
|
C-reactive protein (mg/dL) | 18.2 ± 10.5 | 19.2 ± 11.0 | 11.7 ± 7.1 | 24.1 ± 9.6 | NS |
Albumin (g/dL) | 2.5 ± 0.6 | 2.5 ± 0.7 | 2.7 ± 0.7 | 2.2 ± 0.4 | NS |
Pleural effusion | 19 (79.2) | 14 (87.5) | 2 (40.0) | 3 (100) | NS |
Complicated pleural effusion | 9 (37.5) | 6 (37.5) | 1 (20.0) | 2 (66.7) | NS |
Empyema | 9 (37.5) | 8 (50.0) | 0 (0.0) | 1 (33.3) | NS |
Cultured bacteria | |||||
S. intermedius
| 14 (58.3) | 11 (68.8) | 3 (60.0) | 0 (0.0) | NS |
S. constellatus
| 8 (33.3) | 4 (25.0) | 2 (40.0) | 2 (66.7) | NS |
S. anginosus
| 2 (8.3) | 1 (6.3) | 0 (0.0) | 1 (33.3) | NS |
Pneumonia severity index | 125.2 ± 37.3 | 128.1 ± 37.8 | 123.6 ± 48.6 | 112.0 ± 16.5 | NS |
Total | Pneumonia | Lung abscess | Bacterial pleurisy only |
p-Value | |
---|---|---|---|---|---|
(n = 24) | (n = 16) | (n = 5) | (n = 3) | ||
Monotherapy | 20 (83.3) | 12 (75.0) | 5 (100) | 3 (100) | NS |
Penicillin/beta-lactamase inhibitors | 1 (4.2) | 1 (6.3) | 0 (0.0) | 0 (0.0) | NS |
Carbapenem | 17 (70.8) | 10 (62.5) | 4 (80.0) | 3 (100) | NS |
Linezolid | 1 (4.2) | 0 (0.0) | 1 (20.0) | 0 (0.0) | NS |
Macrolide | 1 (4.2) | 1 (6.3) | 0 (0.0) | 0 (0.0) | NS |
Combination therapy | 4 (16.7) | 4 (25.0) | 0 (0.0) | 0 (0.0) | NS |
4th-cephem + Clindamycin | 1 (4.2) | 1 (6.3) | 0 (0.0) | 0 (0.0) | NS |
Carbapenem + Clindamycin | 2 (8.3) | 2 (12.5) | 0 (0.0) | 0 (0.0) | NS |
Fluoroquinolone + Clindamycin | 1 (4.2) | 1 (6.3) | 0 (0.0) | 0 (0.0) | NS |
Additional treatment | 16 (66.7) | 12 (75.0) | 1 (20.0) | 3 (100) | NS |
Only drainage | 4 (16.7) | 2 (12.5) | 1 (20.0) | 1 (33.3) | NS |
Drainage + lung decortication | 12 (50.0) | 10 (62.5) | 0 (0.0) | 2 (66.7) | NS |
Length of stay (days) | 29.3 ± 19.7 | 31.4 ± 20.9 | 28.6 ± 21.0 | 19.0 ± 9.5 | NS |
ICU admission | 6 (25.0) | 6 (37.5) | 0 (0.0) | 0 (0.0) | NS |
In hospital mortality | 2 (8.3) | 2 (12.5) | 0 (0.0) | 0 (0.0) | NS |