{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T13:13:07Z","timestamp":1777036387892,"version":"3.51.4"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["MicrobiologyOpen"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    To analyze the composition and drug resistance changes of pleural effusion in Shandong region from 2017 to 2024, and to provide a basis for clinical empirical treatment and future public health strategies. Uese the WHONET5.6 software to analyze the data reported by the SPARSS network. A total of 6336 pathogens was isolated, 3876 were Gram\u2010positive bacteria and 2211 were Gram\u2010negative bacteria. The top five pathogens are\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    ,\n                    <jats:italic>Staphylococcus epidermidis<\/jats:italic>\n                    ,\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    ,\n                    <jats:italic>Streptococcus constellatus<\/jats:italic>\n                    , and\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    . The main pathogens in male patients are\n                    <jats:italic>S. constellatus<\/jats:italic>\n                    ,\n                    <jats:italic>S. epidermidis<\/jats:italic>\n                    , and\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    , while in female patients, they are mainly\n                    <jats:italic>S. aureus<\/jats:italic>\n                    ,\n                    <jats:italic>S. epidermidis<\/jats:italic>\n                    , and\n                    <jats:italic>E. coli<\/jats:italic>\n                    . The detection rate of\n                    <jats:italic>S. constellatus<\/jats:italic>\n                    rose from 4.3% to 8.1% after the COVID\u201019 pandemic (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001);\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    rose from 6.9% to 8.9%(\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0264), and its resistance rate to meropenem increased from 2.1% to 18.3% (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0063). The detection rate of methicillin\u2010resistant\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    has remained largely unaffected by the COVID\u201019. The resistance rate of\n                    <jats:italic>Candida albicans<\/jats:italic>\n                    to fluconazole is as high as 12.5%. The pathogen spectrum of pleural effusion in Shandong Province is mainly Gram\u2010positive bacteria. Coagulase\u2010negative staphylococci were among the most common isolates, yet their role as true pathogens versus culture contaminants remains to be clarified in clinical practice. Moreover, after the epidemic, the carbapenem resistance of\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    has significantly increased, and the problem of fungal drug resistance also needs to be paid attention to continuous monitoring to guide the rational use of drugs in clinical practice.\n                  <\/jats:p>","DOI":"10.1002\/mbo3.70285","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T03:37:26Z","timestamp":1776051446000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Influence of COVID\u201019 on the Composition and Drug Resistance of Pleural Effusion in Shandong Province"],"prefix":"10.1002","volume":"15","author":[{"given":"Wenwen","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Clinical Microbiology Jinan Children's Hospital Jinan China"},{"name":"Department of Clinical Microbiology Children's Hospital Affiliated to Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuqing","family":"Ma","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Center, Weihai Municipal Hospital, Cheeloo College of Medicine Shandong University Weihai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fen","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Zhangqiu District Traditional Chinese Medicine Hospital of Jinan City Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangmin","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Zhangqiu District Traditional Chinese Medicine Hospital of Jinan City Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory JiNan ZhangQiu district maternal and child health hospital Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanqi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory The Affiliated Hospital of Qingdao University Qingdao China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sufei","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Shengli Oilfield Central Hospital Dongying China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujun","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Rizhao Municipal Hospital of Traditional Chinese Medicine Rizhao China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunqing","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory People's Hospital of Jinan Zhangqiu district Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fawen","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Hospital Infection Control Dong \u2018e County People's Hospital, Dong \u2018e Liaocheng China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2131-9518","authenticated-orcid":false,"given":"Shifu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology Jinan Children's Hospital Jinan China"},{"name":"Department of Clinical Microbiology Children's Hospital Affiliated to Shandong University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the SPARSS net Working Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10238-021-00751-7"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/clinpract14030068"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad151"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41479-022-00096-z"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2022.2123325"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.13395"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000608"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2024.2359483"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00534-2022"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-022-07978-z"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2021.1878688"},{"key":"e_1_2_10_13_1","unstructured":"CLSI.2022a.Performance Standards for Antifungal Susceptibility Testing of Yeasts. 3rd ed. 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