Oropharyngeal Gram-negative bacillary carriage in chronic obstructive pulmonary disease: relation to severity of disease

Mobbs, K.J.; Saene, H. K. F. van; Sunderland, D.; Davies, P. D. O.

doi:10.1016/s0954-6111(99)90152-x

Cited by 60 publications

(33 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The very low colonization rate upon admission in general ward patients is consistent with the results of a recent study demonstrating that healthy individuals rarely carry oropharyngeal gram-negative bacteria (32). Previously, the severity of underlying disease, mechanical ventilation, and the presence of nasogastric feeding tubes were associated with oropharyngeal gram-negative bacterial colonization (26,31,44). Differences in colonization rates between the ICU and general ward populations and the high colonization rate in specimens obtained during stay in the ICU confirm these earlier findings.…”

Section: Discussionsupporting

confidence: 86%

Colonization and Resistance Dynamics of Gram-Negative Bacteria in Patients during and after Hospitalization

Filius¹,

Gyssens²,

Kershof³

et al. 2005

Antimicrob Agents Chemother

View full text Add to dashboard Cite

The colonization and resistance dynamics of aerobic gram-negative bacteria in the intestinal and oropharyngeal microfloras of patients admitted to intensive care units (ICU) and general wards were investigated during and after hospitalization. A total of 3,316 specimens were obtained from patients upon admission, once weekly during hospitalization, at discharge from the ICU, at discharge from the hospital, and 1 and 3 months after discharge from the hospital. Five colonies per specimen were selected for identification and susceptibility testing. In both patient populations, the gram-negative colonization rates in oropharyngeal specimens increased during hospitalization and did not decrease in the 3 months after discharge. In rectal specimens, colonization rates decreased during hospitalization and increased after discharge. There was a change in species distribution among the dominant microfloras during hospitalization. Klebsiella spp., Enterobacter spp., Serratia marcescens, and Pseudomonas aeruginosa were isolated more often, whereas the frequency of Escherichia coli declined. The percentage of ICU patients colonized with ampicillin-and/or cephalothin-resistant fecal E. coli was significantly increased at discharge from the hospital and did not change in the 3 months after discharge. The emergence of multidrug resistance was observed for E. coli during patient stays in the ICU. Resistance frequencies in E. coli significantly increased with the length of stay in the ICU. For the general ward population, no significant changes in resistance frequencies were found during hospitalization. From a population perspective, the risk of dissemination of resistant gram-negative bacteria into the community through hospitalized patients appears to be low for general ward patients but is noticeably higher among ICU patients.

show abstract

Section: Discussionsupporting

confidence: 86%

Colonization and Resistance Dynamics of Gram-Negative Bacteria in Patients during and after Hospitalization

Filius¹,

Gyssens²,

Kershof³

et al. 2005

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…In further support of this observation, no opportunistic pathogens were reported in any pneumonia episode; however, extensive microbiological investigations were not required or routinely undertaken in every case. Conversely, patients with COPD are chronically colonised with potential pathogens, which complicates ascertaining a specific aetiological agent using noninvasive techniques [9,26,27] and also may not permit differentiation between exacerbation and pneumonia microbiologically.…”

Section: Discussionmentioning

confidence: 99%

“…Mechanisms to explain the increased risk for pneumonia in this population are not fully elucidated, but may in part be related to altered innate host mechanisms that result in increased carriage of potentially pathogenic microorganisms and altered function of immune effector cells [7][8][9][10][11][12][13]. Moreover, the carriage of such pathogenic organisms is related to disease severity, i.e.…”

mentioning

confidence: 99%

“…Moreover, the carriage of such pathogenic organisms is related to disease severity, i.e. increased in patients with worse airflow obstruction (forced expiratory volume in 1 s (FEV1) ,50%) [9][10][11][12][13][14]. In addition, cross-sectional studies have shown increased microbiological colonisation of the lower respiratory tract during exacerbations of COPD compared with the stable state [15,16].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Pneumonia risk in COPD patients receiving inhaled corticosteroids alone or in combination: TORCH study results

Crim¹,

Calverley²,

Anderson³

et al. 2009

Eur Respir J

406

294

View full text Add to dashboard Cite

Inhaled corticosteroids (ICS) are important in reducing exacerbation frequency associated with chronic obstructive pulmonary disease (COPD). However, little is known about the risk of associated infections.In a post hoc analysis of the TOwards a Revolution in COPD Health (TORCH) study, we analysed and identified potential risk factors for adverse event reports of pneumonia in this randomised, double-blind trial comparing twice-daily inhaled salmeterol (SAL) 50 mg, fluticasone propionate (FP) 500 mg, and the combination (SFC) with placebo in 6,184 patients with moderateto-severe COPD over 3 yrs.Despite a higher withdrawal rate in the placebo arm, after adjusting for time on treatment, a greater rate of pneumonia was reported in the FP and SFC treatment arms (84 and 88 per 1,000 treatment-yrs, respectively) compared with SAL and placebo (52 and 52 per 1,000 treatmentyrs, respectively). Risk factors for pneumonia were age o55 yrs, forced expiratory volume in 1 s ,50% predicted, COPD exacerbations in the year prior to the study, worse Medical Research Council dyspnoea scores and body mass index ,25 kg?m -2. No increase in pneumonia deaths with SFC was observed; this could not be concluded for FP.Despite the benefits of ICS-containing regimens in COPD management, healthcare providers should remain vigilant regarding the possible development of pneumonia as a complication in COPD patients receiving such therapies.

show abstract

“…infections and is often implicated in early infectious airway disease in cystic fibrosis patients (2,5,6,22). S. aureus expresses several potential virulence factors (VF) that may induce airway epithelial injury, inactivate host defense mechanisms, and impair the epithelial wound/repair process.…”

mentioning

confidence: 99%

Downregulation by a long-acting β₂-adrenergic receptor agonist and corticosteroid of Staphylococcus aureus-induced airway epithelial inflammatory mediator production

Fragaki

Kileztky²,

Trentesaux³

et al. 2006

American Journal of Physiology-Lung Cellular and Molecular Phys

View full text Add to dashboard Cite

-Although Staphylococcus aureusis a major cause of pulmonary infection, the role played by this bacterium in the induction of inflammation of human airway epithelial cells (HAEC) is poorly understood. In this study, we investigated the inflammatory response of HAEC to S. aureus soluble virulence factors and demonstrate that the combination of a long-acting ␤ 2-adrenergic receptor agonist (salmeterol) with a glucocorticoid (fluticasone propionate) has an anti-inflammatory effect on HAEC. First, we demonstrate increased expression at both the mRNA and protein levels of interleukin (IL)-8, IL-6, and tumor necrosis factor (TNF)-␣ following incubation of HAEC in the presence of S. aureus soluble virulence factors and the increase of 1) the free nuclear factor-B (NF-B) and activator protein-1 (AP-1) activities and 2) the phosphorylated (P-) extracellular signal-regulated kinases 1 and 2 (ERK1/ERK2), the P-c-Jun NH 2-terminal kinase (JNK), and the P-isoform-␣ of the NF-B inhibitor (I B␣). Next, when HAEC were preincubated with the combination of salmeterol and fluticasone propionate, the inflammatory response of HAEC was markedly attenuated in that levels of IL-8, IL-6, TNF-␣, NF-B, AP-1, P-ERK1/ERK2, P-JNK, and P-I B␣ decreased significantly. These data emphasize the deleterious effect of S. aureus soluble virulence factors and suggest that the combination of a ␤2-adrenergic receptor agonist with a glucocorticoid may attenuate the associated airway epithelial inflammation. airway inflammation; proinflammatory cytokines; nuclear fator-B and activator protein-1 activation; glucocorticoid; bacterial virulence factors STAPHYLOCOCCUS AUREUS is one of the most common grampositive bacterial pathogens, involved in airway infections, either primary or subsequent to viral diseases (17). S. aureus is also a major cause of hospital-acquired lower respiratory tract infections and is often implicated in early infectious airway disease in cystic fibrosis patients (2, 5, 6, 22). S. aureus expresses several potential virulence factors (VF) that may induce airway epithelial injury, inactivate host defense mechanisms, and impair the epithelial wound/repair process. The increasing emergence of methicillin-resistant S. aureus requires a better understanding of staphylococcal pathogenesis in infectious and inflammatory airway diseases. S. aureus surface proteins such as adhesins and protein A are produced during exponential growth phase, whereas most exoproteins, including toxins, hemolysins, and tissue-degrading enzymes, are secreted during the stationary phase. Alpha-toxin, one of the major soluble VF of S. aureus, is able to induce transient apoptosis followed by the necrosis of human airway epithelial cells (HAEC) (9). We have also recently shown that live S. aureus and more predominantly soluble VF in contact with HAEC induce marked alterations in the transcriptional expression profile of HAEC associated with activation of the NF-B and activator protein (AP)-1 pathway, upregulation of PGE 2 and cyclooxygenase (COX)-2 expression and pr...

show abstract

Oropharyngeal Gram-negative bacillary carriage in chronic obstructive pulmonary disease: relation to severity of disease

Cited by 60 publications

References 24 publications

Colonization and Resistance Dynamics of Gram-Negative Bacteria in Patients during and after Hospitalization

Colonization and Resistance Dynamics of Gram-Negative Bacteria in Patients during and after Hospitalization

Pneumonia risk in COPD patients receiving inhaled corticosteroids alone or in combination: TORCH study results

Downregulation by a long-acting β₂-adrenergic receptor agonist and corticosteroid of Staphylococcus aureus-induced airway epithelial inflammatory mediator production

Contact Info

Product

Resources

About

Oropharyngeal Gram-negative bacillary carriage in chronic obstructive pulmonary disease: relation to severity of disease

Cited by 60 publications

References 24 publications

Colonization and Resistance Dynamics of Gram-Negative Bacteria in Patients during and after Hospitalization

Colonization and Resistance Dynamics of Gram-Negative Bacteria in Patients during and after Hospitalization

Pneumonia risk in COPD patients receiving inhaled corticosteroids alone or in combination: TORCH study results

Downregulation by a long-acting β2-adrenergic receptor agonist and corticosteroid of Staphylococcus aureus-induced airway epithelial inflammatory mediator production

Contact Info

Product

Resources

About

Downregulation by a long-acting β₂-adrenergic receptor agonist and corticosteroid of Staphylococcus aureus-induced airway epithelial inflammatory mediator production