{"id":24710,"date":"2023-12-07T04:56:00","date_gmt":"2023-12-06T20:56:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24710"},"modified":"2023-12-07T06:04:18","modified_gmt":"2023-12-06T22:04:18","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9aicu%e4%b8%ad%e8%82%ba%e8%84%93%e8%82%bf%e7%9a%84%e6%b5%81%e8%a1%8c%e7%97%85%e5%ad%a6%e4%b8%8e%e4%b8%b4%e5%ba%8a%e7%b1%bb%e5%9e%8b","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24710","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1aICU\u4e2d\u80ba\u8113\u80bf\u7684\u6d41\u884c\u75c5\u5b66\u4e0e\u4e34\u5e8a\u7c7b\u578b"},"content":{"rendered":"\n

ORIGINAL RESEARCH|ARTICLES IN PRESS<\/a><\/p>\n\n\n\n

Epidemiology and clinical patterns of Lung Abscesses in ICU: A French multicenter retrospective study<\/h1>\n\n\n\n

Vinca Montmeat, Vincent Bonny, Tomas Urbina, et al<\/h3>\n\n\n\n

Chest Published:August 28, 2023<\/h3>\n\n\n\n

DOI:https:\/\/doi.org\/10.1016\/j.chest.2023.08.020<\/a><\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Background<\/h3>\n\n\n\n

Data are scarce regarding epidemiology and management of critically ill patients with lung abscesses.<\/p>\n\n\n\n

Research question<\/h3>\n\n\n\n

What are the clinical and microbiological characteristics of critically ill patients with lung abscesses, how are they managed in the ICUs, and what are the risk factors of in-ICU mortality?<\/p>\n\n\n\n

Study Design and Methods<\/h3>\n\n\n\n

Retrospective observational multicenter study, based on ICD-10 codes, between 2015 and 2022 in France. In-ICU mortality-associated factors were determined by multivariate logistic regression.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

We analyzed 171 ICU patients with pulmonary abscesses. 78% were male with a mean age of 56.5 \u00b1 16.4 years. 20.4% were excessive alcohol users, 25.2% had a chronic lung disease (14% COPD), and 20.5% had a history of cancer. Overall, 40.9% were immunocompromised and 38% qualified for nosocomial infection. Presenting symptoms included fatigue or weight loss in 62%, fever (50.3%) and dyspnea (47.4%). Hemoptysis was reported in 21.7%. A polymicrobial infection was present in 35.6%. The most frequent pathogens were Enterobacteriaceae<\/em> in 31%, S. aureus<\/em> in 22% and Pseudomonas aeruginosa<\/em> in 19.3%. 10.5% were fungal infections. Several clusters of clinico-radiological patterns were associated with specific microbiological documentation and could guide empiric antibiotic regimen. 11.7% had percutaneous abscess drainage; surgery was performed in 12.7%, and 12% required bronchial-artery embolization for hemoptysis. In-ICU mortality was 21.5%, and age [OR: 1.05 (1.02-1.91), P<\/em>=0.007], RRT during ICU stay [OR: 3.56 (1.24\u201310.57), P<\/em>=0.019], and fungal infection [OR: 9.12 (2.69-34.5), P<\/em>=0.0006] were independent predictors of mortality after multivariate logistic regression, while drainage or surgery were not.<\/p>\n\n\n\n

Interpretation<\/h3>\n\n\n\n

Pulmonary abscesses in the ICU are a rare but severe disease often resulting from a polymicrobial infection with a high proportion of Enterobacteriaceae, S. aureus<\/em>, and P. aeruginosa<\/em>. Percutaneous drainage, surgery or arterial embolization was required in more than a third of cases. Further prospective studies focusing on first-line antimicrobial therapy and source control procedure are warranted to improve and standardize patient management.<\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL RESEARCH|ARTICLES IN PRESS Epidemiology and cl […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24710"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24710"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24710\/revisions"}],"predecessor-version":[{"id":24711,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24710\/revisions\/24711"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24710"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24710"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24710"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}