Review
Biology
Sean P. F. Foley, John Scott Parrish
Summary: Pleural space infections have been a well-recognized clinical syndrome for over 4000 years and continue to cause significant morbidity and mortality worldwide. Our understanding of the causative pathophysiology has greatly expanded over the last few decades, as have our treatment options. This paper aims to review recent updates in our understanding of pleural space infections and provide updates on treatment modalities.
Article
Medical Laboratory Technology
Chunjuan Dong, Fangfang Shen, Hanquan Dong, Lili Dong, Ya Fu, Yongsheng Xu, Jing Ning
Summary: Community-acquired Pseudomonas aeruginosa pneumonia in immunocompetent children is rare and may present with bloody pleural effusion. Treatment may be complicated by drug resistance, leading to worsening symptoms despite initial improvement. Early extubation should be considered after adequate drainage.
JOURNAL OF CLINICAL LABORATORY ANALYSIS
(2022)
Article
Pediatrics
Matthieu Thimmesch, Andre Mulder, Frederic Lebrun, Frederic Pierart, Caroline Genin, Isabelle Loeckx, Pierre Demaret
Summary: This retrospective study examined the use of corticosteroids in the management of parapneumonic pleural effusion in children. The findings suggest that corticosteroids may be beneficial when conventional treatment fails, with a significant proportion of patients experiencing rapid resolution of fever after initiation of corticosteroid therapy. All patients were discharged from the hospital without the need for surgery.
PEDIATRIC PULMONOLOGY
(2022)
Article
Respiratory System
Mingmei Zhong, Ruiqin Ni, Huizhen Zhang, Yangyang Sun
Summary: This study identifies several clinical factors, such as chest tightness, long duration of fever, low serum albumin, and low blood sodium, as risk factors for the development of pleural effusion in elderly patients with CAP. Early identification and prompt management of these patients can prevent inappropriate treatment and reduce morbidity and mortality.
BMC PULMONARY MEDICINE
(2023)
Article
Pediatrics
I-Fan Chang, Wei-Liang Shih, Yun-Chung Liu, Te-Wei Ho, Ting-Yu Yen, Hsiu-Hao Chang, Luan-Yin Chang, Chi-Tai Fang, Feipei Lai
Summary: Anemia is associated with poor outcomes in pediatric CAP, with iron-deficiency anemia and normocytic anemia being particularly concerning. Patients with these types of anemia should be carefully monitored and managed due to their higher disease severity risks.
PEDIATRIC PULMONOLOGY
(2022)
Letter
Medicine, General & Internal
Jan O. Friedrich, Elisa Gouvea Bogossian
Summary: In a trial evaluating the efficacy of hydrocortisone in treating community-acquired pneumonia, researchers found a nearly 50% lower 28-day mortality rate in the hydrocortisone group compared to the placebo group. They also observed a higher incidence of septic shock in the placebo group. The trial did not allow the use of open-label glucocorticoids, which may have contributed to the higher mortality rate in the placebo group.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Medicine, General & Internal
Paula Duarte D'Ambrosio, Pedro Henrique Xavier Nabuco de Araujo, Eserval Rocha Junior, Mauro Razuk Filho, Paulo Manuel Pego-Fernandes, Ricardo Mingarini Terra
Summary: The study aimed to identify the risk factors for post-pleurodesis empyema after talc slurry pleurodesis. The results showed that antibiotic therapy prior to pleurodesis was an independent risk factor for the development of empyema, and patients with long-duration chest tube placement and incomplete lung expansion also had a higher risk of empyema.
Article
Pharmacology & Pharmacy
Aya Saied, Radwa Maher El Borolossy, Mourad Alfy Ramzy, Nagwa A. A. Sabri
Summary: The supplementation of zinc and vitamin A has positive effects on the recovery of children under 5 years old suffering from community-acquired pneumonia, reducing the length of hospital stay and the duration of pneumonic effusion.
FRONTIERS IN PHARMACOLOGY
(2022)
Article
Critical Care Medicine
Jason Akulian, Eihab O. Bedawi, Hawazin Abbas, Christine Argento, David T. Arnold, Akshu Balwan, Hitesh Batra, Juan Pablo Uribe Becerra, Adam Belanger, Kristin Berger, Allen Cole Burks, Jiwoon Chang, Ara A. Chrissian, David M. DiBardino, Xavier Fonseca Fuentes, Yaron B. Gesthalter, Christopher R. Gilbert, Kristen Glisinski, Mark Godfrey, Jed A. Gorden, Horiana Grosu, Mridul Gupta, Fayez Kheir, Kevin C. Ma, Adnan Majid, Fabien Maldonado, Nick A. Maskell, Hiren Mehta, Joshua Mercer, John Mullon, Darlene Nelson, Elaine Nguyen, Edward M. Pickering, Jonathan Puchalski, Chakravarthy Reddy, Alberto E. Revelo, Lance Roller, Ashutosh Sachdeva, Trinidad Sanchez, Priya Sathyanarayan, Roy Semaan, Michal Senitko, Samira Shojaee, Ryan Story, Jeffrey Thiboutot, Momen Wahidi, Candice L. Wilshire, Diana Yu, Aline Zouk, Najib M. Rahman, Lonny Yarmus
Summary: Combination intrapleural fibrinolytic and enzyme therapy (IET) carries a low overall bleeding risk in pleural infection. The concurrent use of therapeutic anticoagulation increases the bleeding rates, which can be mitigated by withholding anticoagulation before treatment. Parameters related to higher bleeding risk have been identified.
Article
Pediatrics
Gelila Alemayheu, Claire S. J. Lee, Laura K. K. Erdman, Jacqueline Wong, Candy Rutherford, Marek Smieja, Sarah Khan, Jeffrey M. M. Pernica
Summary: This study describes the characteristics of children with community-acquired pneumonia complicated by effusion (cCAP) who were hospitalized. The findings suggest that cCAP patients have prolonged hospital stays, and prompt procedural drainage can shorten the length of stay. Microbiologic diagnosis through pleural fluid testing can accurately determine pathogens and guide antibiotic therapy.
Article
Respiratory System
Alexandra Townsend, Harsha Raju, Krystina A. Serpa, Rachel Pruett, Syed S. Razi, Francisco A. Tarrazzi, Catherine M. Tami, Mark I. Block
Summary: This study retrospectively reviewed the use of low dose tPA with a 12-hour dwell time for the management of complex pleural effusions. The results suggest that this regimen may be as effective as the standard daily tPA and DNAse regimen.
BMC PULMONARY MEDICINE
(2022)
Article
Infectious Diseases
Yoshiki Shiraishi, Kirill Kryukov, Katsuyoshi Tomomatsu, Fumio Sakamaki, Shigeaki Inoue, So Nakagawa, Tadashi Imanishi, Koichiro Asano
Summary: This study aimed to identify probable causative bacteria in pleural empyema/parapneumonic effusions by combining 16S rRNA gene amplification and next-generation sequencing (NGS). NGS results were discordant with culture results in some patients who had been treated with antibiotics. Total and specific bacterial loads calculated using semi-quantitative PCR could efficiently distinguish infectious effusions from non-infectious effusions.
INFECTIOUS DISEASES
(2021)
Article
Critical Care Medicine
Srinivas R. Mummadi, James K. Stoller, Rocio Lopez, Karthik Kailasam, Colin T. Gillespie, Peter Y. Hahn
Summary: This study investigated the epidemiologic measures related to adult pleural diseases in the United States from 2007 to 2016. Significant trends and changes in various pleural diseases were observed, suggesting opportunities for improvement in their management.
Article
Medicine, General & Internal
Damien Basille, Lei Wang, Reimar Wernich Thomsen, Jyothi Menon, Nisha Shetty, Pierre Duhaut, Claire Andrejak, Vincent Jounieaux, Henrik Toft Sorensen
Summary: This study examined the impact of inhaled corticosteroids (ICS) on pneumonia outcomes in chronic obstructive pulmonary disease (COPD) patients with community-acquired pneumonia (CAP). The results suggested that current ICS users had a decreased risk of pleuropulmonary complications, intensive care unit admission, and 30-day mortality compared to non-users. These findings indicate a potential positive effect of ICS use on the prognosis of CAP in COPD patients.
FRONTIERS IN MEDICINE
(2023)
Article
Medicine, General & Internal
Maged Hassan, Shefaly Patel, Ahmed S. Sadaka, Eihab O. Bedawi, John P. Corcoran, Jose M. Porcel
Summary: Pleural infection in adults is a serious and life-threatening condition with increasing incidence especially in older adults. Anaerobic bacteria play a major role in the infection, requiring prolonged hospitalization. Surgical intervention or intrapleural fibrinolytic therapy are recommended for patients who fail standard medical therapy, but early intervention requires further evidence.
INTERNATIONAL JOURNAL OF GENERAL MEDICINE
(2021)
Article
Public, Environmental & Occupational Health
Gabriela Abelenda-Alonso, Mireia Puig-Asensio, Emilio Jimenez-Martinez, Esther Garcia-Lerma, Ana Hornero, Carmen Gutierrez, Miriam Torrecillas, Cristian Tebe, Miquel Pujol, Jordi Carratala
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY
(2023)
Article
Infectious Diseases
Francisco Lopez-Medrano, Santiago Alfayate, Jordi Carratala, Judith Chamorro-Camazon, Elisa Cordero, Marta Cruz-Canete, Maria Fernandez-Prada, Manuel Garcia-Cenoz, Maria Angeles Marcos, Santiago Melon, Nemesio Moreno-Millan, Maria Angeles Onieva-Garcia, Raul Ortiz de Lejarazu, Jaime Jesus Perez-Martin, Juan Rodriguez-Garcia, German Schwarz-Chavarri, Alfredo Tagarro-Garcia, Diego van Esso-Arbolave, Diego Viasus, Tomas Pumarola
Summary: "The influenza virus has significant impacts on individuals and society, putting a burden on the health system. This Consensus Document aims to simplify the approach to influenza virus infection and reduce its consequences on population health." (Source: Published by Elsevier Espana, S.L.U. on behalf of the Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica)
ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA
(2023)
Letter
Infectious Diseases
Alexander Rombauts, Carmen Infante, Mikel del Alamo Martinez de Lagos, Jorge Alba, Adoracion Valiente, Carla Donado-Mazarron, Marta Carretero-Ledesma, Regino Rodriguez-Alvarez, Sonia Omatos, Zaira R. Palacios-Baena, Gabriela Abelenda-Alonso, Maria del Mar Silva-Sanchez, Ane Josune Goikoetxea-Agirre, Jose A. Oteo, Jesus Rodriguez-Bano, Elisa Cordero, Carlota Gudiol, Javier Sanchez-Cespedes, Jordi Carratala
JOURNAL OF INFECTION
(2023)
Article
Immunology
Mario Fernandez-Ruiz, Marta Bodro, Isabel Gutierrez Martin, Regino Rodriguez-Alvarez, Maria Ruiz-Ruigomez, Nuria Sabe, Teresa Lopez-Vinau, Maricela Valerio, Aitziber Illaro, Jesus Fortun, Sonsoles Salto-Alejandre, Elisa Cordero, Maria del Carmen Farinas, Patricia Munoz, Elisa Vidal, Jordi Carratala, Josune Goikoetxea, Antonio Ramos-Martinez, Asuncion Moreno, Jose Maria Aguado
Summary: Retrospective study shows that isavuconazole is a safe and effective treatment option for invasive mold disease in solid organ transplantation recipients. Clinical response was achieved in over 50% of patients by weeks 6 and 12, and adverse events were relatively low.
Article
Surgery
Elena Perez-Nadales, Mario Fernandez-Ruiz, Alejandra M. Natera, Belen Gutierrez-Gutierrez, Alessandra Mularoni, Giovanna Russelli, Ligia Camera Pierrotti, Maristela Pinheiro Freire, Marco Falcone, Giusy Tiseo, Mario Tumbarello, Francesca Raffaelli, Edson Abdala, Marta Bodro, Elena Gervasi, Maria Carmen Farinas, Elena M. Seminari, Juan Jose Caston, Juan Antonio Marin-Sanz, Victor Galvez-Soto, Meenakshi M. Rana, Belen Loeches, Pilar Martin-Davila, Alvaro Pascual, Jesus Rodriguez-Bano, Jose Maria Aguado, Luis Martinez-Martinez, Julian Torre-Cisneros, REIPI INCREMENT-SOT Study Grp
Summary: This study compared the efficacy of ceftazidime-avibactam (CAZ-AVI) and the best available therapy (BAT) in treating solid organ transplant recipients with bloodstream infection caused by carbapenemase-producing Klebsiella pneumoniae. The results showed that patients treated with CAZ-AVI had higher clinical success rates at 14-day and 30-day and lower 30-day mortality compared to those receiving BAT.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Review
Respiratory System
Jose M. Porcel, Rosa Cordovilla, Rachid Tazi-Mezalek, Deisy Barrios-Barreto, Javier Perez-Pallares, Helder Novais e Bastos, Raquel Martinez-Tomas, Javier Flandes-Aldeyturriaga, Enrique Cases-Viedma, Borja Recalde, Maribel Botana-Rial
Summary: Based on the analysis of multiple studies, the timing of systemic cancer therapy (SCT) does not significantly affect the efficacy and safety of indwelling pleural catheters (IPC) in patients with malignant pleural effusion (MPE). Using SCT while the IPC was in situ can reduce overall mortality, increase survival time, and improve quality-adjusted survival.
ARCHIVOS DE BRONCONEUMOLOGIA
(2023)
Article
Immunology
Alexander Rombauts, Marta Bodro, Victor Daniel Gumucio, Irene Carbonell, Alex Fava, Laura Llado, Jose Gonzalez-Costello, Federico Oppenheimer, Maria Angeles Castel-Lavilla, Oscar Len, Ester Marquez-Algaba, Xavier Nuvials-Casals, Daniel Martinez Gonzalez, Judith Sacanell Lacasa, Jordi Carratala, Nuria Sabe
Summary: COVID-19-associated pulmonary aspergillosis (CAPA) is common in the ICU, but little is known about its occurrence in solid organ transplant recipients (SOTRs) and the efficacy of antifungal prophylaxis. A retrospective study compared SOTRs with and without nebulized amphotericin-B prophylaxis, showing a lower incidence of pulmonary mold infections in the prophylaxis group. Nebulized amphotericin-B was found to be safe and potentially effective in reducing the risk of CAPA in SOTRs with COVID-19. Further randomized clinical trials are needed to confirm these findings.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2023)
Article
Infectious Diseases
Judit Aranda, Jose Loureiro-Amigo, Anna Murgadella, Nuria Vazquez, Lucia Feria, Miriam Munoz, Ariadna Padulles, Gabriela Abelenda, Carol Garcia-Vidal, Montse Tuset, Marta Albanell, Lucia Boix-Palop, Nuria Sanmarti-Martinez, Silvia Gomez-Zorrilla, Daniel Echeverria-Esnal, Alicia Rodriguez-Alarcon, Beatriz Borjabad, Ana Coloma, Jordi Carratala, Isabel Oriol
Summary: This study analyzed the prescription trends of COVID-19 treatments for hospitalized patients in Barcelona. The use of lopinavir/ritonavir and hydroxychloroquine declined over time and was replaced by remdesivir. Tocilizumab use showed a varying trend, while dexamethasone use increased. Antibiotic use, particularly azithromycin, decreased after the initial months of the pandemic. The findings highlight the importance of adapting treatment strategies based on evolving scientific evidence.
Article
Infectious Diseases
Javier Martinez-Casanova, Erika Esteve-Pitarch, Helena Colom-Codina, Victor Daniel Gumucio-Sanguino, Sara Cobo-Sacristan, Evelyn Shaw, Kristel Maisterra-Santos, Joan Sabater-Riera, Xose L. Perez-Fernandez, Raul Rigo-Bonnin, Fe Tubau-Quintano, Jordi Carratala, Ariadna Padulles-Zamora
Summary: This study aimed to characterize the pharmacokinetics of piperacillin after continuous infusion administration in critically ill adult patients and determine the optimal dosing regimen. The population pharmacokinetic approach was used to analyze piperacillin concentrations from 106 patients. Creatinine clearance was found to be the most predictive factor of piperacillin clearance. The model developed can be used for initial dose guidance and therapeutic drug monitoring.
Article
Biochemistry & Molecular Biology
Alexander Rombauts, Marta Bodalo Torruella, Gabriela Abelenda-Alonso, Julia Perera-Bel, Anna Ferrer-Salvador, Ariadna Acedo-Terrades, Maria Gabarros-Subira, Isabel Oriol, Carlota Gudiol, Lara Nonell, Jordi Carratala
Summary: The clinical manifestations of SARS-CoV-2 infection vary widely, from asymptomatic infection to severe respiratory complications. The host response to the virus plays a crucial role in determining the outcomes. This study aimed to understand the differences in gene expression and immune response in COVID-19 patients with and without acute respiratory distress syndrome (ARDS). Blood samples were collected from 60 hospitalized patients with confirmed SARS-CoV-2 infection, and significant differences in gene expression were found between the ARDS and non-ARDS groups, including dysregulated inflammatory response and altered immune regulation.
Article
Biochemistry & Molecular Biology
Sara Grillo, Miquel Pujol, Josep M. Miro, Joaquin Lopez-Contreras, Gorane Euba, Oriol Gasch, Lucia Boix-Palop, Maria Jose Garcia-Pais, Maria Teresa Perez-Rodriguez, Silvia Gomez-Zorrilla, Isabel Oriol, Luis Eduardo Lopez-Cortes, Maria Luisa Pedro-Botet, Rafael San-Juan, Jose Maria Aguado, Francesca Gioia, Simona Iftimie, Laura Morata, Alfredo Jover-Saenz, Graciano Garcia-Pardo, Belen Loeches, Alvaro Izquierdo-Cardenas, Ane Josune Goikoetxea, Aina Gomila-Grange, Beatriz Dietl, Damaris Berbel, Sebastian Videla, Pilar Hereu, Ariadna Padulles, Natalia Pallares, Cristian Tebe, Guillermo Cuervo, Jordi Carratala, SAFO Study Grp
Summary: In hospitalized adults with MSSA bacteremia, combining cloxacillin with fosfomycin did not achieve better treatment success at day 7 compared to using cloxacillin alone. Further trials should consider the heterogeneity of the infection and use a personalized approach.
Article
Virology
Jose Luis Pinana, Inmaculada Heras, Tommaso Francesco Aiello, Irene Garcia-Cadenas, Lourdes Vazquez, Javier Lopez-Jimenez, Pedro Chorao, Cristina Aroca, Carolina Garcia-Vidal, Ignacio Arroyo, Eva Soler-Espejo, Lucia Lopez-Corral, Alejandro Avendano-Pita, Anna Arrufat, Valentin Garcia-Gutierrez, Elena Arellano, Lorena Hernandez-Medina, Clara Gonzalez-Santillana, Julia Morell, Jose angel Hernandez-Rivas, Paula Rodriguez-Galvez, Mireia Mico-Cerda, Manuel Guerreiro, Diana Campos, David Navarro, Angel Cedillo, Rodrigo Martino, Carlos Solano
Summary: This study analyzed the outcomes of hematological patients with SARS-CoV-2 infection who received treatment with remdesivir or nirmatrelvir/ritonavir. The results showed that nirmatrelvir/ritonavir was safe and effective for treating mild cases, while remdesivir was preferred for moderate to severe cases with a higher mortality rate. Factors such as male gender, corticosteroid use, and co-infection were associated with worse outcomes in patients treated with remdesivir.
Article
Infectious Diseases
Mar Ronda, Josep Manuel Llop-Talaveron, MariPaz Fuset, Elisabet Leiva, Evelyn Shaw, Victor Daniel Gumucio-Sanguino, Yolanda Diez, Helena Colom, Raul Rigo-Bonnin, Mireia Puig-Asensio, Jordi Carratala, Ariadna Padulles
Summary: This study compared the pharmacokinetics of voriconazole in critically ill patients with and without extracorporeal membrane oxygenation (ECMO) support. The results showed that the ECMO group had lower minimum plasma concentration (C-min) and a higher prevalence of subtherapeutic C-min values. ECMO support and plasma albumin levels were identified as risk factors for low C-min values. Drug optimization is crucial for achieving therapeutic C-min levels in the ECMO group.
Review
Biochemistry & Molecular Biology
Diego Viasus, Lara Nonell, Carlos Restrepo, Fabian Figueroa, Carla Donado-Mazarron, Jordi Carratala
Summary: This study summarizes the reported differentially expressed genes (DEGs) in critically ill septic patients with community-acquired pneumonia (CAP) and investigates their functional implications. The results highlight the complexity of immune responses during CAP.
Article
Immunology
Tomas O. Jensen, Greg A. Grandits, Mamta K. Jain, Thomas A. Murray, Birgit Grund, Kathryn Shaw-Saliba, Michael A. Matthay, Mahsa Abassi, Magdalena Ardelt, Jason V. Baker, Peter Chen, Robin L. Dewar, Anna L. Goodman, Timothy J. Hatlen, Helene C. Highbarger, Mark Holodniy, Perrine Lallemand, Sylvain Laverdure, Bradley G. Leshnower, David Looney, Charalampos D. Moschopoulos, Henry Mugerwa, Daniel D. Murray, Eleftherios Mylonakis, Stephanie Nagy-Agren, M. Tauseef Rehman, Adam Rupert, Randy A. Stevens, Stuart Turville, Amy Weintrob, Katherine Wick, Jens Lundgren, Emily R. Ko
Summary: This study suggests that neutralizing monoclonal antibodies have an antiviral effect among hospitalized patients with COVID-19, without affecting the endogenous anti-nucleocapsid antibody response, systemic inflammation, or clinical status on day 5.
JOURNAL OF INFECTIOUS DISEASES
(2023)