Respiratory Pathogens at Exacerbation in Chronic Bronchitis With Airway Bacterial Colonisation: A Cohort Study

IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM
Thomas L. Jones, Claire Roberts, Scott Elliott, Sharon Glaysher, Ben Green, Janis K. Shute, Anoop J. Chauhan
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引用次数: 0

Abstract

Background and Objective

COPD and bronchiectasis are common causes of morbidity, particularly around exacerbation. Colonisation with respiratory pathogens can increase the frequency and severity of exacerbations. However, bacterial and viral presence at exacerbation in people with airway colonisation has not been well studied.

Methods

A 6-month cohort study of participants (n = 30) with chronic bronchitis due to bronchiectasis (n = 26) and/or COPD (n = 13) and colonisation with Pseudomonas aeruginosa or Haemophilus influenzae was proven on two sputum cultures at exacerbation in the previous 12 months. Participants were provided self-management education and collected sputum samples daily. Sputum samples at baseline (at least 14 days before or after an exacerbation) and at each exacerbation were examined for a panel of 34 respiratory pathogens using commercially available RT-PCR kits and compared to results obtained using culture methods for the detection of bacteria.

Results

Participants provided 29 baseline samples and 71 samples at exacerbation. In 17/29 baseline samples, RT-PCR analysis confirmed the organism demonstrated by culture, while 12 samples showed a discrepancy from culture results. Most exacerbations (57.7%) were not associated with acquiring new bacteria or viruses, while 19.8% showed new bacteria, 15.7% new viruses and 7% both new viruses and bacteria.

Conclusion

Over half of exacerbations were not associated with new organisms in this cohort of participants with chronic bronchitis and colonisation. However, 26.8% demonstrated a new bacterial species in sputum, which is relevant for antibiotic therapy. Baseline RT-PCR and culture results were discordant in one-third of participants.

Abstract Image

气道细菌定植的慢性支气管炎恶化时的呼吸道病原体:队列研究
背景和目的:慢性阻塞性肺病和支气管扩张是常见的发病原因,尤其是在病情加重时。呼吸道病原体定植会增加病情加重的频率和严重程度。然而,关于气道定植患者在病情加重时是否存在细菌和病毒的研究还不够深入:方法:对因支气管扩张(26 人)和/或慢性阻塞性肺病(13 人)而患有慢性支气管炎的参与者(30 人)进行为期 6 个月的队列研究,研究对象在过去 12 个月内病情加重时的两次痰培养均证明其存在铜绿假单胞菌或流感嗜血杆菌定植。参与者接受自我管理教育,并每天采集痰样。使用市售 RT-PCR 试剂盒对基线(病情恶化前后至少 14 天)和每次病情恶化时的痰液样本进行检测,以检测 34 种呼吸道病原体,并将检测结果与使用培养方法检测细菌的结果进行比较:参与者提供了 29 份基线样本和 71 份加重时的样本。在 17/29 份基线样本中,RT-PCR 分析证实了培养所显示的病原体,而 12 份样本与培养结果存在差异。大多数病情恶化(57.7%)与感染新的细菌或病毒无关,19.8%感染了新的细菌,15.7%感染了新的病毒,7%同时感染了新的病毒和细菌:结论:在这批患有慢性支气管炎并有定植的参与者中,超过半数的病情恶化与新生物无关。然而,26.8%的患者痰中出现了新的细菌种类,这与抗生素治疗有关。三分之一的参与者的基线 RT-PCR 和培养结果不一致。
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来源期刊
Clinical Respiratory Journal
Clinical Respiratory Journal 医学-呼吸系统
CiteScore
3.70
自引率
0.00%
发文量
104
审稿时长
>12 weeks
期刊介绍: Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)
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