Education＆ScienceEducational Article

Comment by Mark Lavercombe: Local bacteriology data is critical when empiric treatment of infection is required, and in this paper, the authors have collated data from all patients admitted to one of twenty-five public hospitals in Hong Kong over a nine-year period with community-acquired lung abscess. After exclusion of patients without lung abscess, insufficient data, hospital-acquired infection and mycobacterial or fungal infections, there were 744 cases of which 606 had specimens sent for microbiologic analysis. Several patterns of infection were identified, with patients groing aerobic streptococci more likely to be male and require abscess drainage, while patients growing anaerobes were more likely to have empyema, aspiration and need for surgery. Further patterns were also evident for patients with growth of Staphylococcus aureus, Klebsiella species, Pseudomonas aeruginosa and other gram-negative bacilli. These data can inform local clinical decision making while awaiting specimen testing and in patients who remain ‘culture negative’.