Analysis Of Sputum Bacterial Culture For Chronic Obstructive Pulmonary Disease And Intervention Countermeasures Development During Acute And Chronic

Background:Chronic obstructive pulmonary disease (COPD) is a common diseases of therespiratory system, the characteristic is airway, lung parenchyma and pulmonaryvascular chronic inflammation lead to not fully reversible airflow limitation. As theC0PD sick’s number is very much and the mortality rate is high, It is the heavyburden of social and economic, has become a major public health problem. The worldaverage, ranking cause of death in the first four. According to a study published bythe World Bank/World Health Organization, to2020, COPD will jump to the worldeconomic burden of disease in the first five. Respiratory infections is an importantfactor in the deterioration of COPD exacerbations.Prevention of respiratory tractinfections, reducing COPD exacerbations of great significance for the social costsavings, reduce medical burden and improve the quality of life of patients withCOPD.Objective:To provide a theoretical basis for the further development of targetedintervention strategies by pathogen distribution of patients with chronic obstructivepulmonary disease (COPD) during cute and chronic.Methods:Sputum bacterial culture results of1,107cases of chronic obstructive pulmonarydisease with acute exacerbation were analyzed from July2010to June2012inRespiratory Department of our hospital., line sputum bacterial was cultured in307positive cases of sputum culture during the stable phase, sputum pathogens theconcentration≥107CFU/ml was as a standard diagnostic for the C0PD pathogeninfection.Intervention measures of COPD patients with acute exacerbation and stableperiod were formulated combined with the patient’s general clinical characteristics(gender, age, body mass index, BMI, hypertension, diabetes, smoking history, use ofbronchodilators, inhaled corticosteroids,white blood cell count (WBC), accounted for one second forced expiratory vital capacity percentage (FEV1/FVC), partial pressureof oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), C reactive protein(CRP), tumor necrosis factor (of TNF-α), interleukin-18(IL-18), interleukin-13(IL-13).Result:The clinical characteristics of the patients(age, WBC, FEV1/FVC, PaO2,PaCO2, CRP, TNF-α, IL-18, IL-13) in acute exacerbation was significantly higherthan the stabilization period (P <0.05). Pass rate from389sputum samples in acuteexacerbation was35.1%, there were141bacteria≥107CFU/ml, G-bacilli accountedfor67.4%(95plant), Including Pseudomonas aeruginosa, Acinetobacter baumannii,Haemophilus common; G+cocci accounted for18.4%(26), Mainly streptococcuspneumoniae, Staphylococcus aureus, Staphylococcus haemolyticus; fungi accountedfor14.2%(20), Aspergillus11plant, the candida9plant; Sputum culture positiverate was36.2%; Pass rate was78.9%, in307qualified sputum samples during stable..35strains of sputum samples were detected≥107CFU/ml, G-bacilli accounted for74.2%(26plant), in which P. aeruginosa isolation rate was highest, accounting for40.0%(14), fungi accounted for20.0%(7plant); G+cocci accounted for5.8%(7);Positive rate of sputum bacterial culture was11.4%. positive results of the same were31(31patients) during acute exacerbation and stabilization,13cases ofbronchiectasis,11patients with type2diabetes, hypertension, coronary heart disease,4cases of fracture,3cases no underlying diseases.Conclusions:Sputum specimens qualified were low; Pathogens were mainly gram-negativebacilli; positive sputum culture is low in acute exacerbation, non-bacterial infectionfactors leading to COPD exacerbations can not be ignored; pass rate in stabilizationperiod was significantly higher due to human intervention in the sputum samples, butpositive rate of the sputum culture were lower, mostly associated with bronchiectasis,type2diabetes and other basic diseases, The role of bacterial colonization in theordinary COPD patients with acute exacerbation was worth considering. Patients withCOPD in different periods were afforded appropriate interventions, sputum samples qualified rate can be improved, and to enhance the patient’s own immune system,help reduce empiric medication, shorter hospital stays, avoid excessive waste ofmedical resources and hospital costs...