Table 2 Clinical characteristics, radiological description, microbiological documentation and treatments in patients that developed a lung abscess
VAP with lung abscess (n = 23) | |
|---|---|
Main delays, days, median (IQR) | |
Time from beginning of MV to diagnosis of LA | 18 (14–27) |
Time from 1st VAP to diagnosis of LA | 13 (4–23) |
Number of VAP episodes | |
One | 8 (35) |
Two | 9 (39) |
Three or more | 6 (26) |
Radiological data | |
Reason for chest CT scan, n (%) | |
LA suspicion | 16 (70) |
Other indication | 7 (30) |
Number of abscesses on chest CT scan, n (%) | |
One | 11 (48) |
Two or more | 12 (52) |
Thoracic lateralization, n (%) | |
Right lung | 10 (43) |
Left lung | 6 (26) |
Bilateral | 7 (30) |
Thoracic location | |
Upper lobe | 7 (30) |
Lower lobe | 8 (35) |
Upper and lower lobes | 8 (35) |
Widest diameter, mm, median (IQR) | 50 (37–80) |
Visibility of LA on chest radiography before CT scan, n (%) | 11 (48) |
Associated pulmonary embolism or thrombosis, n (%) | 8 (35) |
History of pulmonary embolism or thrombosis during stay, n (%) | 4 (17) |
Microbiological data, n (%) | |
Microbiological documentation (yes/no) | 21 (91) |
Number of bacteria involved | |
One | 8 (35) |
Plurimicrobial | 15 (65) |
Bacterial documentation | |
Enterobacterales | 15 (65) |
Klebsiella spp. | 4 (17) |
Escherichia coli | 3 (13) |
Enterobacter spp. | 4 (17) |
Other | 1 (4) |
Non-fermenting Gram-negative Bacilli | 10 (43) |
Pseudomonas aeruginosa | 6 (26) |
Acinetobacter spp. | 3 (13) |
Stenotrophomonas maltophilia | 1 (4) |
Gram-positive cocci | 8 (35) |
Methicillin-susceptible Staphylococcus aureus | 6 (26) |
Methicillin-resistant Staphylococcus aureus | 1 (4) |
Enterococcus faecalis | 1 (4) |
Anaerobes | |
Bacillus cereus | 1 (4) |
Fungal documentation | 9 (39) |
Aspergillus fumigatus | 8 (35) |
Associated bacteremia | 11 (48) |
Antibiotic treatment | |
Cephalosporins | 17 |
Piperacillin–tazobactam | 4 |
Carabapenems | 8 |
Aminoglycosids | 16 |
Ciprofloxacin | 9 |
Vancomycin | 2 |
Linezolid | 6 |
Cotrimoxazole | 5 |
Colistin | 3 |
New beta-lactams (± inhibitors)a | 6 |
Mono-therapy | 0 |
Bi-therapy or more | 23 |
Inhaled or instilled antibiotics | 13 |
Antibiotic duration, days, median (IQR) | 29 (15–43) |
Thoracic drainage and/or decortication of pleural empyema | 7 (30) |
Complications, n (%) | |
Pleural empyema | 4 (17) |
Pneumothorax | 8 (35) |
Control CT scan, n (%) | 15 (65) |
Time from LA diagnosis to 2nd CT scan (median, IQR) | 14 (8–25) |
Worsening | 5 (33) |
Unchanged | 5 (33) |
Improvement | 5 (33) |