Infectious Aetiology of Acute Exacerbations in Severe COPD Patients.
J Infect. 2013 Sep 19;
Authors: Domenech A, Puig C, Martí S, Santos S, Fernández A, Calatayud L, Dorca J, Ardanuy C, Liñares J
Abstract
OBJECTIVES: Since the new GOLD guidelines were implemented no data have been published about the etiology of acute exacerbations (AECOPD) in severe COPD patients with a different frequency of annual episodes.
METHODS: One hundred and eleven COPD patients (FEV1<50%) were prospectively followed up for a year. Good-quality sputum samples recovered during AECOPD were processed, including quantitative culture and PCR detection of atypical bacteria.
RESULTS: A total of 188 sputum samples were obtained from AECOPD episodes. Forty patients had a single episode, and 71 patients had ≥2. In 128 episodes a single pathogen was isolated, while 42 episodes were polymicrobial (≥2 pathogens). Overall, the most frequent pathogen isolated was Pseudomonas aeruginosa (n=54), followed by Haemophilus influenzae (n=37), Streptococcus pneumoniae (n=31), Moraxella catarrhalis (n=29) and Staphylococcus aureus (n=12. P. aeruginosa was the most frequent in both groups of patients (35% and 27% in those with 1 and ≥2 AECOPD, respectively). H. influenzae was associated with patients with a single annual AECOPD (33% vs. 16%; P=0.006), while Enterobacteriaceae were associated with frequent exacerbators (0% vs. 12%; P<0.044).
CONCLUSION: Overall, P. aeruginosa was the most frequent pathogen isolated from exacerbations. However, different bacterial etiology was observed depending on the number of annual episodes.
PMID: 24055804 [PubMed - as supplied by publisher]