Analysis Of Sputum Color And Distribution Of Bacterial Genera In Patients With Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

Objective By quantitatively grading the sputum of patients with acute exacerbation of chronic obstructive pulmonary disease,analyze the color of sputum of patients with acute exacerbation of chronic obstructive pulmonary disease and the distribution of bacterial species,and understand the advantages of causing acute exacerbation of patients with chronic obstructive pulmonary disease The relationship between the types of microorganisms and the color of sputum provides a basis for the rational use of antibiotics in clinical practice.Method The sputum of patients with acute exacerbation of chronic obstructive pulmonary disease who did not use antibiotics was collected,and the sputum color was graded by the Bronko Test color chart.The patients were divided into two groups according to the sputum color level: 1-2 grades were mucus sputum group;Grade 3-5 is the purulent sputum group,describing the correlation between sputum color and sputum cytology.In addition,the enrolled patients are divided into low-risk group and high-risk group according to the number of onsets in the past year;according to the carbon dioxide partial pressure,they are divided into no type II respiratory failure group and type II respiratory failure group;according to lung function,GOLD1 and 2 are one group(slightly decreased lung function),GOLD 3 and 4 are another group(serious decreased).Finally,16 S r DNA sequencing technology was used to detect the bacterial genera of sputum,and the differences of bacterial genera between samples were analyzed and compared with the sputum color classification.At the same time,Wilcoxon rank sum test and Kruskal-Wallis rank sum test were used for analysis.Other differences in the distribution of bacterial genera among different groups.Result A total of 106 samples were collected,including 13 cases in the mucus sputum group and 93 cases in the purulent sputum group.The median proportion of sputum neutrophils in the purulent sputum group was higher than that in the mucous sputum group,and the sputum color grade was positively correlated with the proportion of sputum neutrophils.After performing PCR on 106 samples,100 qualified samples obtained 1741 OUTs,including 15 phyla,21 classes,43 orders,44 families,and 62 genera.Further analysis of bacterial genera showed that the relative abundance of Streptococcus in the mucous sputum group was higher than that in the purulent sputum group,while Lactobacillus and Pseudomonas saccharophila were different in the purulent sputum group than in the mucous sputum group.Secondly,patients with acute exacerbation of chronic obstructive pulmonary disease combined with type II respiratory failure are more likely to have Pseudomonas infection,and there are certain differences in the Sartorius spp.in the type II respiratory failure group compared with the type II respiratory failure group.In addition,the patients with mild lung function are mainly streptococcus,while the patients with severe lung function are mainly Staphylococcus.Conclusion The color of sputum in patients with acute exacerbation of chronic obstructive pulmonary disease is closely related to inflammation.According to the changes in sputum,it helps to evaluate the patient’s condition,guide the timing and types of antibiotics,and provide a basis for clinical diagnosis and treatment and patient self-management.