Microbiologic determinants of exacerbation in chronic obstructive pulmonary disease
Microbiologic determinants of exacerbation in chronic obstructive pulmonary disease
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DOI：
10.1001/archinte.165.8.891
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发表时间：
2005-04-25
影响因子：
--
通讯作者：
Torres, A
中科院分区：
文献类型：
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作者：
Rosell, A;Monsó, E;Torres, A
背景：在稳定期慢性阻塞性肺疾病(COPD)患者下呼吸道分泌物培养中，潜在致病微生物(PPM)培养呈阳性，但这种细菌负荷在气道中的决定因素和作用尚未确定。方法：为了确定COPD患者的支气管微生物类型及其与病情恶化的关系，我们采用保护性标本刷检方法，以年龄、性别、吸烟、肺功能和下呼吸道微生物学特征为独立变量，以病情恶化为结果，采用Logistic回归模型分析研究数据。结果：337名研究参与者中，70名健康，181名COPD患者病情稳定，有86人加重了COPD。参与实验室的微生物特性差异在统计学上没有显著差异。在健康个体的合并分析中，定义了每毫升10(2)个集落形成单位(CFU)或更大的临界点，用于识别PPM的异常阳性培养结果。53例稳定期COPD患者(29%)和46例COPD急性加重期患者(54%)PPMS的支气管壁定植达到或超过10(2)cfu/ml(P
Background: The culture of bronchial secretions from the lower air-way has been reported to be positive for potentially pathogenic microorganisms (PPMs) in patients with stable chronic obstructive pulmonary disease (COPD), but the determinants and effects of this bacterial load in the airway are not established.Methods: To determine the bronchial microbial pattern in COPD and its relationship with exacerbation, we pooled analysis of crude data from studies that used protected specimen brush sampling, with age, sex, smoking, lung function, and microbiologic features of the lower airway as independent variables and exacerbation as the outcome, using logistic regression modeling.Results: Of 337 study participants, 70 were healthy, 181 had stable COPD, and 86 had exacerbated COPD. Differences in the microbial characteristics in the participating laboratories were not statistically significant. A cutoff point of 10(2) colony-forming units (CFU) per milliliter or greater for the identification of abnormal positive culture results for PPMs was defined using the 95th percentile in the pooled analysis of healthy individuals. Bronchial colonization of 10(2) CFU/mL or greater by PPMs was found in 53 patients with stable COPD (29%) and in 46 patients with exacerbated COPD (54%) (p