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

• DOI: 10.1378/chest.116.1.40
• Publication Date: 2003-06-14T00:09:19Z
• Authors: Marc Miravitlles; Cristina Espinosa; Enrique Fernández...; José Alberto Martos; José Antonio Mald...; Miguel Gallego
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

Study objectives: To investigate the possible relationship between functional respiratory impairment measured by FEV1 and isolation of diverse pathogens in the sputum of patients with exacerbations of COPD. Design: Multicenter, cross-sectional, epidemiologic study. Setting: Pneumology units in six secondary or tertiary hospitals in Spain. Patients: Ninety-one patients with acute exacerbation of COPD were included. Interventions: A quantitative sputum culture was performed, and bacterial growth was considered significant only when the germ was isolated at concentrations > 10 6 cfu (> 10 5 for Streptococcus pneumoniae) in samples with 25 leukocytes per low magnification field (3100). Results: Germs isolated were the following: Haemophilus influenzae (20 cases; 22%), Pseudomonas aeruginosa (14 cases; 15%), S pneumoniae (9 cases; 10%), Moraxella catarrhalis (8 cases; 9%), other Gram-negative bacteria (7 cases; 7%), and non-potentially pathogenic microorganisms (non-PPMs; 33 cases; 36%). P aeruginosa and H influenzae were isolated more frequently among the patients with FEV1 50% (p 50% was low, with a predominance of non-PPMs. Low FEV1 and active tobacco smoking are data that should be considered when establishing an empiric antibiotic treatment for exacerbated COPD. (CHEST 1999; 116:40 ‐ 46)