Optimización del diagnóstico etiológico en niños hospitalizados por empiema pleural y sus beneficios

Abstract

Introduction: Pleural empyema (PE) is a serious complication of children with community-acquired pneumonia (CAP); the culture of blood and / or pleural fluid (PF) confirms etiology in 5-10% of cases of CAP and 40% in PE. The incorporation of new techniques increases the probability of etiological confirmation. Objective: Describe changes in aetiological diagnosis and its impact on the care of children with PE. Specific: A. Describe microbiological techniques. B. Compare microbiological results in children with PE in 2 periods: 1/1/2011 to 31/12/2017 and 1/1/2018 to 31/12/2018 (year of beginning of systematic use of new techniques). C. Analyze treatment adequacy according to results. Material and methods: Descriptive study. Population: under 15 years with PE. Samples: blood culture and PF. Microbiological techniques: 1. Direct smear and culture. 2. Detection of capsular antigens (ags) in LP. 3. Detection of nucleic acids (NA) in PF and positive blood cultures. Sources: clinical and laboratory records. Results: A. Microbiological techniques are described. B. Microbiological results. a) 1/1/2011 to 31/12/2017. PE = 211. Hospitalization rate/10,000 discharges: 29. Bacterial isolates (blood/PF cultures): 78 (36.9%): S. pneumoniae 45 cases, Others: H. influenzae, S. pyogenes, S.