The difference in clinical characteristics and outcomes between hospital acquired pleural infection and community acquired pleural infection

Abstract

Abstract Background: This study intends to describe the clinical characteristics and microbiological features, drug resistance situations and outcomes associated with hospital acquired and community acquired pleural infection (PI) in a large Chinese tertiary-care hospital in Beijing, China. Methods: The patients were divided into hospital acquired and community acquired pleural infection groups. The basic clinical data of the two groups were collected and statistically analyzed, and the outcomes and prognostic factors of PI were summarized. Results: There were 832 patients with PI over a history of 10 years in the hospital. Among them, 84.86% were hospital-acquired pleural infection (HAPI) and 15.14% were community-acquired pleural infection (CAPI). The most common cause of CAPI was pneumonia and tuberculous pleurisy, but malignant tumor, thoracic surgery and trauma were the most common cause of HAPI. The thoracic catheterization ≥10 days, abdominal catheterization, broad-spectrum antibiotics were used more than 2 days before PI, serum albumin and adenosine deaminase levels of HAPI and CAPI were statistically different. Gram-negative bacteria showed varying degrees of resistance to almost antibiotic, while there were hardly any Gram-positive bacteria resistant to linezolid and vancomycin except Enterococcus faecium, which has shown resistance to vancomycin(9.88%). The 30-day mortality after the onset of PI was 13.1%, and there was no significant statistical difference in prognosis between the patients with CAPI and HAPI. The multivariate logistics analysissuggested that ICU admission, solid tumor, chronic renal failure and decreasedserum albumin level were independent risk factors for PI. Conclusion: There are differences in clinical characteristics between HAPI and CAPI, which should be paid more attention and got individualized treatment in clinical.