Microbiology and progress of the diagnosis and treatment of pleural infection / 中华临床感染病杂志

ABSTRACT

Pleural infection is a common disease associated with increasing morbidity and high mortality. Factors such as age, geographical area, settings of infection (hospital or community acquired)or certain underlying diseases can influence the microbiology of pleural infection. Thus, understanding the microbiology of pleural infection is of vital importance to guide therapeutic decisions. Since the positive rate of conventional cultures is low among cases of pleural infection, new diagnostic methods such as 16S ribosomal RNA (16S rRNA)and metagenomic next-generation sequencing(mNGS)have broad prospects in clinical applications. 16S rRNA and mNGS improves the etiologic diagnosis of pleural infection, facilitating the decision of appropriate anti-infection regimens. The treatment of pleural infection includes appropriate anti-infection regimen, pleural drainage, intrapleural therapy and the need for medical thoracoscopy or surgery. It is convinced that the use of intra-pleural DNase and t-PA has exhibited excellent therapeutic effects in pleural infection and reduced the need for surgery. This paper summarizes recent literatures on the microbiologic characteristics of pleural infection and progress of diagnosis and treatment, aimed to provide clinical evidence for the management of pleural infection.