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.

Asthmatic bronchitis for 2 years: A case report

2003 ◽  
Vol 44 (4) ◽  
pp. 392-394
Author(s):  
I. Starakis ◽  
M. Mylona ◽  
K. Spyropoulos ◽  
P.A. Dimopoulos
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Underlying Disease ◽  
Chronic Obstructive ◽  
Lower Respiratory Tract Infections ◽  
Aged Patients ◽  
Obstructive Pulmonary Disease ◽  
Asthmatic Bronchitis ◽  
Tract Infections

Longstanding asthmatic bronchitis, without evidence of underlying disease, occurring in middle-aged patients, is usually attributed to chronic obstructive pulmonary disease and is treated appropriately. We report a case of 2-year asthmatic bronchitis with recurrent attacks of wheezing, in a 60-year-old patient. He had three repeated hospitalizations, in different institutions, where he was treated for exacerbations of chronic bronchitis complicated by lower respiratory tract infections. During his final hospitalization, a tracheal hamartoma was found and removed, releasing him from his symptoms.

scholarly journals Appropriate antibiotic management of bacterial lower respiratory tract infections

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1121 ◽  
Author(s):  
Charles Feldman ◽  
Guy Richards
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Empiric Therapy ◽  
Community Acquired Pneumonia ◽  
Chronic Obstructive ◽  
Lower Respiratory Tract Infections ◽  
Pneumococcal Infections ◽  
Obstructive Pulmonary Disease ◽  
Tract Infections

Lower respiratory tract infections are the leading cause of infectious disease deaths worldwide and are the fifth leading cause of death overall. This is despite conditions such as pneumococcal infections and influenza being largely preventable with the use of appropriate vaccines. The mainstay of treatment for the most important bacterial lower respiratory tract infections, namely acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and community-acquired pneumonia (CAP), is the use of antibiotics. Yet despite a number of recent publications, including clinical studies as well as several systematic literature reviews and meta-analyses, there is considerable ongoing controversy as to what the most appropriate antibiotics are for the empiric therapy of CAP in the different settings (outpatient, inpatient, and intensive care unit). Furthermore, in the case of AECOPD, there is a need for consideration of which of these exacerbations actually need antibiotic treatment. This article describes these issues and makes suggestions for appropriately managing these conditions, in the setting of the need for antimicrobial stewardship initiatives designed to slow current emerging rates of antibiotic resistance, while improving patient outcomes.

scholarly journals Identification of Surface Antigens of Moraxella catarrhalis as Targets of Human Serum Antibody Responses in Chronic Obstructive Pulmonary Disease

2005 ◽  
Vol 73 (6) ◽  
pp. 3471-3478 ◽  
Author(s):  
Timothy F. Murphy ◽  
Aimee L. Brauer ◽  
Christoph Aebi ◽  
Sanjay Sethi
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Respiratory Tract ◽  
Pulmonary Disease ◽  
Moraxella Catarrhalis ◽  
Outer Membrane Proteins ◽  
Serum Antibody ◽  
Antibody Responses ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Tract Infections

ABSTRACT Moraxella catarrhalis is an important respiratory tract pathogen, causing otitis media in children and lower respiratory tract infections in adults with chronic obstructive pulmonary disease (COPD). Adults with COPD make antibody responses to M. catarrhalis following infection, but little is known about the identity of the antigens to which these antibodies are directed. In this study, 12 serum samples obtained from adults with COPD who had cleared M. catarrhalis from the respiratory tract following infection and who had developed new serum immunoglobulin G (IgG) to their infecting strain were subjected to a series of assays to identify the antigens to which potentially protective antibodies were directed. Sera were adsorbed with intact bacterial cells, and antibodies were eluted from the surfaces of the bacteria. Analysis by flow cytometry established that adsorption and elution effectively detected antibodies specifically directed to surface-exposed epitopes. Immunoblot assays of adsorbed and eluted serum fractions were performed with purified outer membranes and purified lipooligosaccharide of homologous infecting strains and with a series of mutants deficient in expression of individual outer membrane proteins (OMPs). While heterogeneity in antibody responses among individuals was observed, five major OMPs, UspA1, UspA2, Hag, TbpB, and OMP CD, were identified as targets of antibodies to surface epitopes in the majority of adults with COPD who cleared the organism. These results have important implications in understanding human immune responses to M. catarrhalis and in elucidating the elements of a protective immune response.

scholarly journals Investigation of the effect of N-Acetylcysteine on colistin mic values in Acinetobacter Baumannii strains isolated from clinical samples

2021 ◽  
Vol 38 (4) ◽  
pp. 471-473
Author(s):  
Fahriye EKŞİ ◽  
Mehmet ERİNMEZ
Keyword(s):  
Respiratory Tract ◽  
Acinetobacter Baumannii ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Clinical Samples ◽  
Chronic Obstructive ◽  
Identification System ◽  
Lower Respiratory Tract Infections ◽  
Broth Microdilution Method ◽  
Tract Infections

Acinetobacter baumannii is an opportunistic pathogen which colonize inpatients and cause severe infections, septic shock and death. With emergence of multi-drug resistant gramnegative species and being effective in A. baumannii infections, colistin becomes a treatment option again. N-acetylcysteine (NAC), is a mucolitic agent which used commonly in lower respiratory tract infections especially patients who have cronic respiratory disorders like Chronic obstructive pulmonary disease, cystic fibrosis and bronchiectasis. In this study we aim to investigate the effect of NAC, which commonly added in lower respiratory tract infections tratment regime, on MIC values colistin used in A. baumanni tratment. Fifty A.baumannii isolates were included in the study. The isolates were identified by automated identification system. With broth microdilution method, we investigated and compared the MIC (minimum inhibitory concentration) values of colistin and NAC+Colistin combination. Colistin MIC50 value is 0.25 μg/mL and MİK90 value is 1 μg/mL, NAC+Colistin combination MIC50 value is 0.25 μg/mL and MİK90 value is 1 μg/mL. The screening for the effectiveness of clinical drugs may provide clinical strategy to improve treatment outcomes of A. baumannii and reduce hospitalization days.

Sign in / Sign up

Export Citation Format

Share Document