Relationship Between Bacteria Pathogens In Sputum And Lung Function With Acute Exacerbations Of COPD

Objective: To investigate the sputum bacteriology and the possible relationship between functional respiratory impairment and isolation of diverse bacteria pathogens in the sputum of patients with acute exacerbations of COPD. Methods: All 128 cases of patients with acute exacerbations of COPD were collected from 2002 to 2004 in the First Hospital Affiliated Jiangxi Medical College,and 61 cases of patients whose sputum culture were positive.The cases were all according to the diagnostic criteria of Chinese Respiratory Academy in 2002 of COPD. Retrospective surveyes were carried out and the data were examined for 128 cases of patients with acute exacerbations of COPD with positive sputum culture. Results: Germs isolated were the following:Pseudomonas (13 cases;10.16%),S.pneumoniae(7 cases;5.47%),Enteric bacilli(10 cases;7.81%),Acinetobacters(10 cases;7.81%),K.pneumoniae(7 cases;5.47%), Staphylococcus(6 cases;4.69%),other bacteria pathogens(8 cases;6.25%),and non-potentially pathogenic microorganisms(non-PPMs) (67 cases;52.34%).There were 61 cases with positive result of sputum culture , The rate of positive result was about 47.66%. Pseudomonas and Enteric bacilli were isolated more frequently among the patients with FEV1%﹤50% than among those with FEV1%≥50% ,FEV1%﹤50% was associated with a very high risk of Pseudomonas and Enteric bacilli isolation: p﹤0.05,the odds ratios(ORs) were 12.00 and 9.00. Conclusion:Patients with acute exacerbations of COPD were assocated with bacteria pathogens infection including Gram-negative bacillus, such as Pseudomonas , Enteric bacilli , Acinetobacters and K.pneumoniae ,and Gram-positive bacteria ,such as S.pneumoniae and Staphylococcus. Patients with the greatest degree of functional impairment,as measured by their FEV1%,presented a higher probability of having an isolation of Pseudomonas and Enteric bacilli in significant concentrations in sputum during an exacerbation ,especially when FEV1%﹤50%.The diagnostic yield of sputum in patients with an FEV1%≥50% was low,with a predominance of non-potentially pathogenic microorganisms.