ETIOLOGICAL DIAGNOSIS AND PHARMACOTHERAPEUTIC
MANAGEMENT OF PARAPNEUMONIC PLEURISY
DANIELA CĂLINA1#, LUCICA ROȘU2#, ALEXANDRA FLORIANA ROȘU3#, GABRIEL IANOŞI4#, SIMONA IANOŞI5#, OVIDIU ZLATIAN2#, RADU MITRUȚ6#, ANCA OANA DOCEA7#*, OTILIA ROGOVEANU8#, PAUL MITRUȚ9#, ALINA CRENGUȚA NICOLAE10#, CRISTINA MANUELA DRĂGOI10#, ELIZA GOFIȚĂ7#
1Clinical Pharmacy Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
2Microbiology Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
3Internal Medicine Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
4Surgery Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
5Dermatology Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
6Pathology Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
7Toxicology Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
8Physiotherapy Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
9Internal Medicine Department, University of Medicine and Pharmacy of Craiova, Craiova, Romania
10Biochemistry Department, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
*corresponding author: ancadocea@gmail.com
# All authors have equal contribution
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Abstract:
Pleurisy is an inflammatory process characterized by the accumulation of fluid in the pleural cavity. The most frequent
complication of pneumonia is the pleural effusion that can become infected and that needs microbiological analysis of the
pleural fluid for an individualized treatment. The aim of this study was to identify the cases of infectious pleurisy by isolating
and identifying pathogens in the pleural fluid and determining their antimicrobial susceptibility for a targeted and effective
therapy and also to establish antimicrobial resistance phenotypes of the isolated germs. The study was conducted between
04.05.2014 - 01.12.2015 on 150 patients, diagnosed with pleurisy hospitalized in Craiova Emergency County Hospital in in
surgical wards: thoracic surgery, general surgery and intensive care. Pathogens were isolated in 43.33% of the pleural fluids.
Etiological infective agents palette was diverse, represented by Staphylococcus aureus, methicillin resistant Staphylococcus
aureus (MRSA), Streptococcus pyogenes, Enterococcus, Escherichia coli, Klebsiella spp., Pseudomonas spp., nonfermenters
Gram negative rods, anaerobic bacteria and Candida albicans. A high proportion of isolated strains showed
resistance to chemotherapeutic agents with broad spectrum, which indicates their nosocomial potential. Antimicrobial
susceptibility testing is absolutely necessary, in order to choose the most effective therapy.

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