Relationship Between Bacterial Flora in Sputum and Functional Impairment in Patients With Acute Exacerbations of COPD

Miravitlles, Marc; Espinosa, Cristina; Fernández-Laso, Enrique; Martos, J. A.; Maldonado, J.; Gallego, Miguel

doi:10.1378/chest.116.1.40

Cited by 401 publications

(350 citation statements)

References 22 publications

Supporting

Mentioning

267

Contrasting

Unclassified

Order By: Relevance

“…A PPM was isolated in 46.4% of samples from patients with a type I or II exacerbation, with almost 60% of culture-positive samples being from green sputum and only 18.4% from white sputum. Consistent with other studies [15], H. influenzae was the PPM most often isolated in our large series and we found no specific colour pattern for the different PPMs present in sputum samples.…”

Section: Discussionsupporting

confidence: 92%

Sputum colour and bacteria in chronic bronchitis exacerbations: a pooled analysis

Miravitlles

Kruesmann²,

Haverstock³

et al. 2011

Eur Respir J

Self Cite

View full text Add to dashboard Cite

We examined the correlation between sputum colour and the presence of potentially pathogenic bacteria in acute exacerbations of chronic bronchitis (AECBs).Data were pooled from six multicentre studies comparing moxifloxacin with other antimicrobials in patients with an AECB. Sputum was collected before antimicrobial therapy, and bacteria were identified by culture and Gram staining. Association between sputum colour and bacteria was determined using logistic regression.Of 4,089 sputum samples, a colour was reported in 4,003; 1,898 (46.4%) were culture-positive. Green or yellow sputum samples were most likely to yield bacteria (58.9% and 45.5% of samples, respectively), compared with 18% of clear and 39% of rust-coloured samples positive for potentially pathogenic microorganisms. Factors predicting a positive culture were sputum colour (the strongest predictor), sputum purulence, increased dyspnoea, male sex and absence of fever. Green or yellow versus white sputum colour was associated with a sensitivity of 94.7% and a specificity of 15% for the presence of bacteria.Sputum colour, particularly green and yellow, was a stronger predictor of potentially pathogenic bacteria than sputum purulence and increased dyspnoea in AECB patients. However, it does not necessarily predict the need for antibiotic treatment in all patients with AECB.

show abstract

Section: Discussionsupporting

confidence: 92%

Sputum colour and bacteria in chronic bronchitis exacerbations: a pooled analysis

Miravitlles

Kruesmann²,

Haverstock³

et al. 2011

Eur Respir J

Self Cite

View full text Add to dashboard Cite

show abstract

“…Community acquired pathogens (S. pneumonia, H. influenzae) were responsible in 31% of the total isolates. Our findings are in accordance with Miravitlles et al [10] reports including H. influenza, P. aeruginosa, and S. pneumonia as the most frequent isolates in sputum samples of COPD patients with exacerbation [11]. Interestingly, we observed P. aeruginosa as the leading pathogen isolated from sputum samples of COPD patients with exacerbation.…”

Section: Discussionsupporting

confidence: 93%

“…The most common causes are bacterial or viral respiratory tract infections. Streptococcus pneumonia, Haemophilus influenzae and Moraxella catarrhalis were the most frequently isolated microorganisms in AECOPD patients [9,10]. Prevention, early detection, and prompt treatment of exacerbations are vital to reduce the burden of COPD.…”

Section: Introductionmentioning

confidence: 99%

Bacterial etiology in acute hospitalized chronic obstructive pulmonary disease exacerbations

Dilektaşlı¹,

Cetinoglu²,

Öztürk³

et al. 2016

Eur Res J

View full text Add to dashboard Cite

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

show abstract

“…Acute exacerbations of COPD are sudden worsening of symptoms in which bacterial colonisation is one major aetiological factor [4][5][6][7]. However, the dynamics of bacterial ecology during exacerbations and its role in disease pathogenesis remain poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Lung microbiome dynamics in COPD exacerbations

et al. 2016

View full text Add to dashboard Cite

Increasing evidence suggests that the lung microbiome plays an important role in chronic obstructive pulmonary disease (COPD) severity. However, the dynamics of the lung microbiome during COPD exacerbations and its potential role in disease aetiology remain poorly understood.We completed a longitudinal 16S ribosomal RNA survey of the lung microbiome on 476 sputum samples collected from 87 subjects with COPD at four visits defined as stable state, exacerbation, 2 weeks post-therapy and 6 weeks recovery.Our analysis revealed a dynamic lung microbiota where changes appeared to be associated with exacerbation events and indicative of specific exacerbation phenotypes. Antibiotic and steroid treatments appear to have differential effects on the lung microbiome. We depict a microbial interaction network for the lung microbiome and suggest that perturbation of a few bacterial operational taxonomic units, in particular Haemophilus spp., could greatly impact the overall microbial community structure. Furthermore, several serum and sputum biomarkers, in particular sputum interleukin-8, appear to be highly correlated with the structure and diversity of the microbiome.Our study furthers the understanding of lung microbiome dynamics in COPD patients and highlights its potential as a biomarker, and possibly a target, for future respiratory therapeutics. @ERSpublications Lung microbiome changes are associated with COPD exacerbation events and implicated in host inflammatory responses

show abstract

Relationship Between Bacterial Flora in Sputum and Functional Impairment in Patients With Acute Exacerbations of COPD

Cited by 401 publications

References 22 publications

Sputum colour and bacteria in chronic bronchitis exacerbations: a pooled analysis

Sputum colour and bacteria in chronic bronchitis exacerbations: a pooled analysis

Bacterial etiology in acute hospitalized chronic obstructive pulmonary disease exacerbations

Lung microbiome dynamics in COPD exacerbations

Contact Info

Product

Resources

About