PT  - JOURNAL ARTICLE
AU  - Fei Wang
AU  - Luoman Yang
AU  - Meng Wang
AU  - Bei He
TI  - Low blood eosinophil count is associated with gram-positive cocci infection and poor clinical outcomes in severe exacerbations of COPD
AID  - 10.1183/13993003.congress-2020.4719
DP  - 2020 Sep 07
TA  - European Respiratory Journal
PG  - 4719
VI  - 56
IP  - suppl 64
4099  - http://erj.ersjournals.com/content/56/suppl_64/4719.short
4100  - http://erj.ersjournals.com/content/56/suppl_64/4719.full
SO  - Eur Respir J2020 Sep 07; 56
AB  - Background: Individualized management of acute exacerbation of COPD (AECOPD) could optimize patients’ benefit. Blood eosinophils may be associated with bacterial pathogen subtypes and clinical outcomes.Methods: We retrospectively recruited 596 patients hospitalized for AECOPD. The exacerbations were grouped according to blood eosinophil count as the eosinophilic (≥2%) and the eosinopenia (< 2%). Exacerbations were classified as being associated with bacterial infection if either CRP ≧2mg/dl or with at least two of the three symptoms: increase in dyspnea, sputum volume, and sputum purulence, among them, sputum purulence was required. Bacterial culture of sputum and drug sensitivity tests were performed. Bacterial infection, pathogen subtypes, hospital and ICU length of stay, need for mechanical ventilation (MV), mortality during hospitalization were compared.Results: Eosinopenia exacerbation was more strongly associated with bacterial infection (47.7% vs 35.6%, P < 0.01), higher CRP and procalcitonin levels. Sputum culture bacterial profiles were different between the two groups. G+ cocci load, especially Staphylococcus (P = 0.006) and Enterococcus (P = 0.013), was significant higher in the eosinopenia. Low eosinophils were also associated with poor clinical outcomes specifically in longer ICU stay (P = 0.047) and more need for MV (P = 0.033).Conclusions: Low eosinophils could hint more G+ cocci infection in exacerbations of COPD, especially Staphylococcus and Enterococcus. Eosinophils should be integrated into the clinical treatment strategy of AECOPD to achieve individualized and precise treatment.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 4719.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).