Clinical and etiological characteristics of parapneumonic effusion infected by anaerobic bacteria analyzed by metagenomic next-generation gene sequencing

ZHANG Ying; LI Yue-chuan; ZHANG Yong-xiang; MA Hui; YE Zhen; LU Fang

doi:10.19538/j.nk2024060111

Abstract：Objective To analyze etiological and clinical characteristics of parapneumonic effusion infected by anaerobic bacteria through metagenomic next-generation sequencing(mNGS).Methods The clinical data of 96 patients hospitalized in the Respiratory and Critical Care Medicine First Ward of Tianjin Chest Hospital from January 2020 to December 2022 were selected,who were with pneumonia with parapneumonic effusion indicated by thoracic tube drainage and had examination of pleural effusion(mNGS).Clinical data were obtained by reviewing medical records.According to the results of mNGS,the patients were divided into anaerobic bacteria infection group and non-anaerobic bacteria infection group.The bacteria distribution,clinical symptoms,basic diseases,laboratory examination,disease onset time,drainage frequency,treatment time and pleural effusion type of patients in the two groups were collected,analyzed and counted.Results A total of 54 cases of parapneumonic effusion infected by anaerobic bacteria were detected,mainly peptostreptococcus and porphyromonas.The proportion of male patients,time of onset,alcohol consumption,oral disease,combination with sleep apnea,low albumin level,D-dimer and C-reactive protein in patients with parapneumonic effusion infected by anaerobic bacteria were higher than those in non-anaerobic infection group(P＜0.05).Logistic multiple regression results showed that alcohol drinking,oral disease,onset time and albumin level were the influencing factors of anaerobic bacteria infection in parapneumonic effusion(P＜0.05).The types of parapneumonic effusion infected by anaerobic bacteria were mainly complicated parapneumonic effusion,and the frequency of drainage,length of hospital stay and thoracic urokinase injection were higher than those in non-anaerobic bacteria group,and the cure rate was lower than that of non-anaerobic group,the differencesbeing statistically significant(P＜0.05).Conclusion For patients with community-acquired pneumonia with anaerobe infection and parapneumonic effusion,oral condition,drinking history,sleep snoring and other conditions should be paid attention to when medical treatment is given.If patients had the above high-risk factors,they should be highly vigilant of the combination of anaerobic infection,and empirically anti-anaerobic therapy should be given in early stage to shorten the treatment time and reduce complications.