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<p>The need for antimicrobial stewardship in managing infectious conditions cannot be overemphasized, as it is vital to curbing antimicrobial resistance. Empyema thoracis is commonly encountered in the Nigerian setting. Still, data describing the spectrum of pathogens is sparse in the literature and further complicated by the lack of studies stating the antimicrobial susceptibility profile of pathogens. Over the past two decades, we identified only four observational studies and eight individual cases highlighting the microbial agents associated with empyema thoracis. Of the four studies, three stated the predominance of Gram-positive pathogens such as <i>Streptococcus pneumoniae</i> and <i>Staphylococcus aureus</i>. On the contrary, one study reported the emergence of Gram-negative pathogens such as <i>Klebsiella pneumoniae</i>, <i>Pseudomonas aeruginosa</i>, and <i>Escherichia coli</i>. <i>Mycobacterium tuberculosis</i> was implicated in two studies, and fungal pathogens, <i>Candida</i> and <i>Histoplasma</i>, in one study, despite studies from other regions showing fungal pathogens are amply involved in the causation of empyema thoracis. Of the four studies, only one demonstrated the antimicrobial susceptibility profiles of the associated pathogens and highlighted their resistance to commonly prescribed antibiotics. There is an urgent need to prioritise studies to understand the microbial profile of empyema thoracis in our setting and, more importantly, to identify the resistance profile of these pathogens, thereby averting inappropriate antibiotic use and enhancing effective antibiotic treatment.</p>

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The Spectrum of Pathogens Associated with Empyema Thoracis in Nigeria and the need for Antimicrobial Stewardship: A Systematic Review

  • 期刊论文

  • 发表日期：

    2026年4月15日

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  • Stella Chukwuma,
  • Chimaobi Nwagboso,
  • Asukwo Onukak,
  • Agbo Etim,
  • Olaedo Imanyikwa,
  • Thelma Bassey,
  • Geraldine Edim,
  • Precious Uche,
  • Walter Egbara,
  • Simon Ereh,
  • Adeyinka Davies,
  • Bassey Ekeng

摘要

The need for antimicrobial stewardship in managing infectious conditions cannot be overemphasized, as it is vital to curbing antimicrobial resistance. Empyema thoracis is commonly encountered in the Nigerian setting. Still, data describing the spectrum of pathogens is sparse in the literature and further complicated by the lack of studies stating the antimicrobial susceptibility profile of pathogens. Over the past two decades, we identified only four observational studies and eight individual cases highlighting the microbial agents associated with empyema thoracis. Of the four studies, three stated the predominance of Gram-positive pathogens such as Streptococcus pneumoniae and Staphylococcus aureus. On the contrary, one study reported the emergence of Gram-negative pathogens such as Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Mycobacterium tuberculosis was implicated in two studies, and fungal pathogens, Candida and Histoplasma, in one study, despite studies from other regions showing fungal pathogens are amply involved in the causation of empyema thoracis. Of the four studies, only one demonstrated the antimicrobial susceptibility profiles of the associated pathogens and highlighted their resistance to commonly prescribed antibiotics. There is an urgent need to prioritise studies to understand the microbial profile of empyema thoracis in our setting and, more importantly, to identify the resistance profile of these pathogens, thereby averting inappropriate antibiotic use and enhancing effective antibiotic treatment.