A Prospective Study on Bacterial and Atypical Etiology of Acute Exacerbation in Chronic Obstructive Pulmonary Disease

Νάκου, Αλεξάνδρα; Papaparaskevas, Joseph; Diamantea, Filia; Skarmoutsou, Nikoletta; Polychronopoulos, Vlasis; Tsakris, Athanassios

doi:10.2217/fmb.14.90

Cited by 22 publications

(28 citation statements)

References 35 publications

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“…Despite this obvious shortcoming the experimental approach described here provides preliminary evidence in support of the hypothesis that there is a host response to the microbiome in COPD and that it is primarily directed at OTUs within the expanding Proteobacteria and Actinobacteria phyla that have successfully competed for space on a reduced alveolar surface. Furthermore, even though none of the patients receiving a transplant had an exacerbation at the time of transplantation, we postulate that the milieu present within the lung microbiome might encourage the emergence of strains from within the expanding Proteobacteria phylum, which is known to contribute many of the organisms that produce acute exacerbations of COPD (36,37). n Author disclosures are available with the text of this article at www.atsjournals.org.…”

Section: Discussionmentioning

confidence: 99%

Host Response to the Lung Microbiome in Chronic Obstructive Pulmonary Disease

Sze

Dimitriu²,

Suzuki

et al. 2015

Am J Respir Crit Care Med

208

159

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Rationale: The relatively sparse but diverse microbiome in human lungs may become less diverse in chronic obstructive pulmonary disease (COPD). This article examines the relationship of this microbiome to emphysematous tissue destruction, number of terminal bronchioles, infiltrating inflammatory cells, and host gene expression. Measurements and Main Results: Ten operational taxonomic units (OTUs) was found sufficient to discriminate between control and GOLD stage 4 lung tissue, which included known pathogens such as Haemophilus influenzae. We also observed a decline in microbial diversity that was associated with emphysematous destruction, remodeling of the bronchiolar and alveolar tissue, and the infiltration of the tissue by CD4 1 T cells. Specific OTUs were also associated with neutrophils, eosinophils, and B-cell infiltration (P , 0.05). The expression profiles of 859 genes and 235 genes were associated with either enrichment or reductions of Firmicutes and Proteobacteria, respectively, at a false discovery rate cutoff of less than 0.1. Conclusions:These results support the hypothesis that there is a host immune response to microorganisms within the lung microbiome that appears to contribute to the pathogenesis of COPD.

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Section: Discussionmentioning

confidence: 99%

Host Response to the Lung Microbiome in Chronic Obstructive Pulmonary Disease

Sze

Dimitriu²,

Suzuki

et al. 2015

Am J Respir Crit Care Med

208

159

View full text Add to dashboard Cite

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“…isolates in respiratory samples of COPD patients with severe exacerbations. Previous studies have demonstrated a significant variation in the relative incidence of specific pathogens in AECOPD, which may relate to patient inclusion criteria, settings and environmental or epidemiological factors [10,[19][20][21][22]. Nearly 15% of our study group had at least two prior admissions in the previous year before enrollment into this study.…”

Section: Discussionmentioning

confidence: 99%

Bacterial etiology in acute hospitalized chronic obstructive pulmonary disease exacerbations

Dilektaşlı¹,

Cetinoglu²,

Öztürk³

et al. 2016

Eur Res J

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Objectives. The most common cause of acute COPD exacerbation (AECOPD) is the respiratory tract infections. We sought to determine the bacteriological etiology of hospitalized acute exacerbations of COPD requiring hospitalization in consecutive two years. Methods. We aimed to determine the bacteriological etiology underlying in patients whom admitted to Uludag University Faculty of Medicine, Department of Pulmonary Medicine and hospitalized with AECOPD in the last two years. Medical records of the study participants were screened retrospectively and sociodemographic characteristics, routine laboratory tests and sputum culture results were analyzed. Results. A total of 242 patients hospitalized for AECOPD were enrolled. Of these 86.4% (n=209) were male. The mean age of the group was 66.6±11 years old. Sputum cultures were available in the 45 % (n=109) of the study group. The most frequent bacteria isolated from the sputum cultures of the study group were Pseudomonas aeruginosa, Streptococcus pneumonia, Haemophilus influenzae and Acinetobacter baumanii. Length of stay was longer in patients with the A. baumanii isolate than the rest of the group (p=0.024). Length of stay in hospital was independently associated with in-hospital mortality (OR: 1.37, 95% CI: 1.05-1.78). Isolation of A. baumanii and/or Staphylococcus aureus in sputum culture were identified as independent risk factors for prolonged length of stay in-hospital (b=0.26, p=0.008; b=15.40, p=0.003). Conclusions. Our study shows that P. aeruginosa, S. pneumonia, H. influenzae are common sputum isolates in AECOPD patients requiring hospitalization. Isolation of A. baumanii and/or S. aureus in sputum culture is associated with prolonged length of stay in hospital, which is an independent risk factor for in-hospital mortality.Eur Res J 2016;2(2):99-106

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“…Nevertheless, the largest increase in the number of participants with the Acinetobacter-induced exacerbation of COPD was registered in critically ill patients. In this patient population, a serious resistance to antimicrobials and a significant increase in mortality rates [22,23,24] were detected. In addition, such an increased frequency of Acinetobacter in RS reveals the inadequate use of empirical antimicrobials, especially in the "out-patient" environment, the insufficient treatment of previous COPD exacerbations, colonization with a new germ, irrational antimicrobial, and entire epidemiological management of hospital isolates.…”

Section: Variablementioning

confidence: 90%

Initial respiratory specimen bacteriology and isolates susceptibility to antimicrobials in promptly intubated chronic obstructive pulmonary disease adults - single-center two-year experience

et al. 2019

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Introduction/Objective Chronic obstructive pulmonary disease (COPD) exacerbation is mostly triggered by infectious agents and seriously compromises the patient's quality of life and predicts a poor outcome of the disease as well. If the signs of the probable bacterial cause of COPD exacerbation are presented in an intubated patient, initial antimicrobial management must be launched. Depending on the results of the respiratory system sample cultures, the initial antimicrobials can be changed or continued. The objective of this study is to present in-hospital suggestions regarding the use of the initial antimicrobial management of urgently intubated COPD adults with the probable bacterial cause of exacerbations, considering the source of bacterial acquisition (i.e. facility-or community-acquired bacteria). Methods The cross-sectional study covered 51 patients urgently intubated on admission to the medical Intensive Care Unit of the Zemun Clinical Hospital Center during 2015/2016. The patients were divided into two groups: community-acquired (n = 26) and facility-acquired infection group (n = 25). The respiratory system samples were processed in the Microbiology Laboratory. Results Acinetobacter and Pseudomonas spp. were the most frequently isolated bacteria in both groups, followed by Staphylococcus aureus and Klebsiella spp. as the third most frequent bacteria in the community-and facility-acquired group, respectively. The parallel use of tigecycline and aminoglycosides proved to cover a sensitive microbial spectrum in 52% of examinees of the community-acquired and 32% of examinees of the facility-acquired group. Conclusion The present study suggests the initial management of intubated adults with probable bacterial infection-induced COPD exacerbation by the parallel use of tigecycline and aminoglycosides.

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A Prospective Study on Bacterial and Atypical Etiology of Acute Exacerbation in Chronic Obstructive Pulmonary Disease

Cited by 22 publications

References 35 publications

Host Response to the Lung Microbiome in Chronic Obstructive Pulmonary Disease

Host Response to the Lung Microbiome in Chronic Obstructive Pulmonary Disease

Bacterial etiology in acute hospitalized chronic obstructive pulmonary disease exacerbations

Initial respiratory specimen bacteriology and isolates susceptibility to antimicrobials in promptly intubated chronic obstructive pulmonary disease adults - single-center two-year experience

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