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Title: Understanding the Lung Abscess Microbiome: Outcomes of Percutaneous Lung Parenchymal Abscess Drainage with Microbiologic Correlation

Abstract

IntroductionLung parenchymal abscesses represent an uncommon pathology with high mortality if untreated. Although most respond well to antibiotics, the optimal therapy for persistent abscesses is unknown. The purpose of this study was to review the outcomes of percutaneous lung parenchymal abscess catheter drainage after broad-spectrum antibiotic therapy failure and correlate with patient microbiologic samples.Materials and MethodsRetrospective review of patients who underwent percutaneous lung abscess drainage at a tertiary hospital system from 2005 to 2015 was performed. In total, 19 procedures were identified on 16 different patients; six females and ten males. Mean patient age was 55 years (range 22–81). Median follow-up time was 7 months (range <1–78).ResultsTechnical success was 100%. There was one major complication, a pneumothorax. Follow-up was until tube removal or death in 100% of patients. Catheters were removed with resolution of the abscess cavity in 58% (11/19) or with non-draining abscess cavities in 21% (4/19) for a clinical success rate of 79%. Blood cultures demonstrated no growth in all cases, while 21% (4/19) of sputum or bronchoscopic cultures demonstrated growth. In comparison, the specimens from initial catheter placement isolated a causative organism in 95% (18/19) of case (p < 0.0001).ConclusionIn cases of persistent lung abscess after broad-spectrum antibiotics, percutaneous abscess drainagemore » is highly sensitive for microbiologic sampling compared to sputum/bronchoscopic or blood cultures. Additionally, percutaneous drainage of lung parenchymal abscess cavities may promote resolution of the abscess with high rates of therapeutic success and low complications.« less

Authors:
; ; ;  [1]
  1. Hospital of the University of Pennsylvania, Perelman School of Medicine, Division of Interventional Radiology, Department of Radiology (United States)
Publication Date:
OSTI Identifier:
22645164
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 6; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABSCESSES; ANTIBIOTICS; BLOOD; CORRELATIONS; DEATH; DRAINAGE; FAILURES; GROWTH; HOSPITALS; LUNGS; MORTALITY; PATHOLOGY; PATIENTS; RESOLUTION; REVIEWS; THERAPY

Citation Formats

Duncan, Christopher, Nadolski, Gregory J., Gade, Terence, and Hunt, Stephen, E-mail: Stephen.hunt@uphs.upenn.edu. Understanding the Lung Abscess Microbiome: Outcomes of Percutaneous Lung Parenchymal Abscess Drainage with Microbiologic Correlation. United States: N. p., 2017. Web. doi:10.1007/S00270-017-1623-3.
Duncan, Christopher, Nadolski, Gregory J., Gade, Terence, & Hunt, Stephen, E-mail: Stephen.hunt@uphs.upenn.edu. Understanding the Lung Abscess Microbiome: Outcomes of Percutaneous Lung Parenchymal Abscess Drainage with Microbiologic Correlation. United States. doi:10.1007/S00270-017-1623-3.
Duncan, Christopher, Nadolski, Gregory J., Gade, Terence, and Hunt, Stephen, E-mail: Stephen.hunt@uphs.upenn.edu. Thu . "Understanding the Lung Abscess Microbiome: Outcomes of Percutaneous Lung Parenchymal Abscess Drainage with Microbiologic Correlation". United States. doi:10.1007/S00270-017-1623-3.
@article{osti_22645164,
title = {Understanding the Lung Abscess Microbiome: Outcomes of Percutaneous Lung Parenchymal Abscess Drainage with Microbiologic Correlation},
author = {Duncan, Christopher and Nadolski, Gregory J. and Gade, Terence and Hunt, Stephen, E-mail: Stephen.hunt@uphs.upenn.edu},
abstractNote = {IntroductionLung parenchymal abscesses represent an uncommon pathology with high mortality if untreated. Although most respond well to antibiotics, the optimal therapy for persistent abscesses is unknown. The purpose of this study was to review the outcomes of percutaneous lung parenchymal abscess catheter drainage after broad-spectrum antibiotic therapy failure and correlate with patient microbiologic samples.Materials and MethodsRetrospective review of patients who underwent percutaneous lung abscess drainage at a tertiary hospital system from 2005 to 2015 was performed. In total, 19 procedures were identified on 16 different patients; six females and ten males. Mean patient age was 55 years (range 22–81). Median follow-up time was 7 months (range <1–78).ResultsTechnical success was 100%. There was one major complication, a pneumothorax. Follow-up was until tube removal or death in 100% of patients. Catheters were removed with resolution of the abscess cavity in 58% (11/19) or with non-draining abscess cavities in 21% (4/19) for a clinical success rate of 79%. Blood cultures demonstrated no growth in all cases, while 21% (4/19) of sputum or bronchoscopic cultures demonstrated growth. In comparison, the specimens from initial catheter placement isolated a causative organism in 95% (18/19) of case (p < 0.0001).ConclusionIn cases of persistent lung abscess after broad-spectrum antibiotics, percutaneous abscess drainage is highly sensitive for microbiologic sampling compared to sputum/bronchoscopic or blood cultures. Additionally, percutaneous drainage of lung parenchymal abscess cavities may promote resolution of the abscess with high rates of therapeutic success and low complications.},
doi = {10.1007/S00270-017-1623-3},
journal = {Cardiovascular and Interventional Radiology},
number = 6,
volume = 40,
place = {United States},
year = {Thu Jun 15 00:00:00 EDT 2017},
month = {Thu Jun 15 00:00:00 EDT 2017}
}