[Bacterial flora in acute exacerbations of chronic obstructive pulmonary disease (COPD) in Kunming, China]

Med Mal Infect. 2011 Apr;41(4):186-91. doi: 10.1016/j.medmal.2010.11.009. Epub 2010 Dec 30.
[Article in French]

Abstract

Objective: Chinese recommendations for the management of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) include antibiotic treatments targeting the most frequently isolated pathogens according to the severity of COPD. The study objective was to check the relevance of these recommendations in Yunnan, a Southern Chinese province.

Patients and methods: A descriptive and analytical survey was conducted in the Kunming Medical University hospital among patients over 60 years of age, hospitalized with AECOPD, between March 2007 and June 2008.

Results: The 74 included patients were predominantly male (90%), with a mean age of 78.6 years, active or ex-smokers (81%), mainly with moderate (43%) or severe COPD (34%). Out of 87 AECOPD episodes, 47 (54%) yielded significant quantitative sputum cultures for S. pneumoniae (10%), P. aeruginosa (10%), H. influenzae (7%), M. catarrhalis (7%), and K. pneumoniae (7%). The positivity of sputum cultures was significantly linked with a history of smoking (P=0.002). More than half of the P. aeruginosa isolates were multidrug resistant.

Conclusions: The distribution of pathogens isolated from EABPCO in Kunming corroborates published results. It does not question Chinese recommendations for first-line antibiotic therapy, but the high prevalence of P. aeruginosa and Enterobacteriaceae requires a periodic screening for acquired antibiotic resistance.

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Bacteria / isolation & purification*
  • China / epidemiology
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Haemophilus influenzae / isolation & purification
  • Hospitals, University / statistics & numerical data
  • Humans
  • Klebsiella pneumoniae / isolation & purification
  • Male
  • Middle Aged
  • Moraxella catarrhalis / isolation & purification
  • Pneumonia, Bacterial / drug therapy
  • Pneumonia, Bacterial / epidemiology
  • Pneumonia, Bacterial / etiology
  • Pneumonia, Bacterial / microbiology*
  • Practice Guidelines as Topic
  • Prevalence
  • Pseudomonas aeruginosa / drug effects
  • Pseudomonas aeruginosa / isolation & purification
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / microbiology*
  • Severity of Illness Index
  • Smoking / epidemiology
  • Sputum / microbiology
  • Streptococcus pneumoniae / isolation & purification

Substances

  • Anti-Bacterial Agents