Abstract
Bacterial infections are a major cause of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) resulting in significant mortality and morbidity. This study was undertaken to investigate the bacterial spectrum of AECOPD requiring hospitalization.
We examined 40 patients with COPD hospitalized for infectious AECOPD according to Anthonisen's criteria. We measured lung function, and assessed sputum for inflammation and for bacterial infection using PCR. All patients had no previous intubation and none was diagnosed with pneumonia.
Patients were hospitalized for 9±3 (mean ± SD) days. AECOPD were associated with impaired lung function (FEV1: 42±20, FVC: 69±11, FEV1/FVC: 52±16), respiratory failure and increased sputum neutrophilia (mean ± SD, 72±26). PCR revealed pathogens in 88% of the sputum samples analyzed. The most commonly isolated pathogens were S. pneumonia (65%), Haemophilus influenzae (45%), Ps. aeruginosa (33%), Klebsiella (7.5%), and Mycoplasma Hominis (7.5%).
A mixed flora was revealed in 52.5% of sputum samples. The most common co-infection identified was by S. pneumonia and Haemophilus influenzae (35%), followed by S. pneumonia and Ps. aeruginosa (25%). In 12.5% there was a co-infection by three bacterial strains (S. pneumonia, Haemophilus influenzae, and Ps. aeruginosa).
S. pneumonia and Haemophilus influenzae were the commonest sputum pathogens isolated in hospitalized patients with infectious AECOPD. Interestingly, in more than 50% of the cases a co-infection by 2 or three different strains was revealed. These results should be considered when deciding the initial antibiotic treatment in Greek patients with AECOPD.
- © 2011 ERS
