Value of the Aspergillus Culture of Lower Respiratory Tract Samples in Diagnosing Chronic Obstructive Pulmonary Disease With Invasive Pulmonary Aspergillosis

CHEST Journal ◽  
2011 ◽  
Vol 140 (4) ◽  
pp. 271A
Author(s):  
Shuo Chang ◽  
Hangyong He ◽  
Ding Lin ◽  
Fang Li ◽  
Bing Sun ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Tract ◽  
Pulmonary Disease ◽  
Lower Respiratory Tract ◽  
Invasive Pulmonary Aspergillosis ◽  
Chronic Obstructive ◽  
Pulmonary Aspergillosis ◽  
Obstructive Pulmonary Disease

scholarly journals Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease

2013 ◽  
Vol 8 ◽  
Author(s):  
Nuri Tutar ◽  
Gokhan Metan ◽  
Ayşe Nedret Koç ◽  
Insu Yilmaz ◽  
Ilkay Bozkurt ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Amphotericin B ◽  
Clinical Status ◽  
Invasive Pulmonary Aspergillosis ◽  
Positive Culture ◽  
Common Finding ◽  
Chronic Obstructive ◽  
Pulmonary Aspergillosis ◽  
Obstructive Pulmonary Disease

Background: Invasive pulmonary aspergillosis (IPA) is an infection often occurring in neutropenic patients and has high mortality rates. In recent years, it has been reported that the incidence of IPA has also increased in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study is to investigate the clinical and demographic characteristics and treatment responses of IPA in patients with COPD. Methods: Seventy-one patients with a positive culture of Aspergillus from lower respiratory tract samples were examined retrospectively. Eleven (15.4%) of these patients, affected with grade 3 or 4 COPD, had IPA. Results: Aspergillus hyphae were detected in lung biopsy in three (27.3%) out of 11 patients and defined as proven IPA; a pathological sample was not taken in the other eight (72.7%) patients, and these were defined as probable IPA. Aspergillus isolates were identified as six cases of Aspergillusfumigatus and three of Aspergillusniger in nine patients, while two isolates were not identified at species level. While five patients required intensive care unit admission, four of them received mechanical ventilation. The most common finding on chest X-ray and computed tomography (CT) (respectively 63.6%, 72.7%) was infiltration. Amphotericin B was the initial drug of choice in all patients and five patients were discharged with oral voriconazole after amphotericin B therapy. Six patients (54.5%) died before treatment was completed. Conclusions: IPA should be taken into account in the differential diagnosis particularly in patients with severe and very severe COPD presenting with dyspnea exacerbation, poor clinical status, and a new pulmonary infiltrate under treatment with broad-spectrum antibiotics and steroids.

scholarly journals Impact of Chronic Obstructive Pulmonary Disease on Incidence, Microbiology and Outcome of Ventilator-Associated Lower Respiratory Tract Infections

2020 ◽  
Vol 8 (2) ◽  
pp. 165 ◽  
Author(s):  
Anahita Rouzé ◽  
Pauline Boddaert ◽  
Ignacio Martin-Loeches ◽  
Pedro Povoa ◽  
Alejandro Rodriguez ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Tract ◽  
Pulmonary Disease ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Chronic Obstructive ◽  
Lower Respiratory Tract Infections ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Tract Infections

Objectives: To determine the impact of chronic obstructive pulmonary disease (COPD) on incidence, microbiology, and outcomes of ventilator-associated lower respiratory tract infections (VA-LRTI). Methods: Planned ancillary analysis of TAVeM study, including 2960 consecutive adult patients who received invasive mechanical ventilation (MV) > 48 h. COPD patients (n = 494) were compared to non-COPD patients (n = 2466). The diagnosis of ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia (VAP) was based on clinical, radiological and quantitative microbiological criteria. Results: No significant difference was found in VAP (12% versus 13%, p = 0.931), or VAT incidence (13% versus 10%, p = 0.093) between COPD and non-COPD patients. Among patients with VA-LRTI, Escherichia coli and Stenotrophomonas maltophilia were significantly more frequent in COPD patients as compared with non-COPD patients. However, COPD had no significant impact on multidrug-resistant bacteria incidence. Appropriate antibiotic treatment was not significantly associated with progression from VAT to VAP among COPD patients who developed VAT, unlike non-COPD patients. Among COPD patients, patients who developed VAT or VAP had significantly longer MV duration (17 days (9–30) or 15 (8–27) versus 7 (4–12), p < 0.001) and intensive care unit (ICU) length of stay (24 (17–39) or 21 (14–40) versus 12 (8–19), p < 0.001) than patients without VA-LRTI. ICU mortality was also higher in COPD patients who developed VAP (44%), but not VAT(38%), as compared to no VA-LRTI (26%, p = 0.006). These worse outcomes associated with VA-LRTI were similar among non-COPD patients. Conclusions: COPD had no significant impact on incidence or outcomes of patients who developed VAP or VAT.

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