A Study On The Relationship Between Pathogen And Lung Function In Patients With Acute Exacerbations Of COPD

Objectives To investigate the pathogenic characteristics and the possible relationship between pathogen and respiratory functional impairment in patients with acute exacerbations of COPD(AECOPD).Methods sixty-four patients witn AECOPD were investigated with lung function test, quantitative sputum bacteria culture, drug sensitive test, Mycoplasma pneumoniae and Chlamydia pneumoniae specific antibodies test, and thirty-eight inpatients among them were simultaneously measured with quantitative sputum bacteria culture. The patients were separated into three groups according to predicted value of FEV₁ percent, and infective bacteria according to the result of sputum culture was divided into four kinds: kind A was Gram-positive cocci(including streptococcus pneumoniae et al), kind B Gram-negtive except kind C, kind C Acinetobacter,Enterobacter and Pseudomonas spp, kind D negative result. To analyze the correlation between the severe degree of lung function impairment in three groups and the diverse kinds of infective bacteria.Results First,Positive sputum culture rate was 75.0%(48/64)among sixty-four patients with AECOPD who were conducted quantitative sputum culture, Germs isolated were mostly the followings: Streptococcus pneumoniae(37.5%), Enterobacter(12.6%), Moraxella Catarrhalis (10.4%), Pseudomonas(8.4%)and Streptococcus viridans(8.3%).Of thirty-eight patients with AECOPD who were conducted qualititative sputum culture, the positive sputum culture rate was 68.4%(26/38), most of them were found mixed infection, Germs isolated were mostly Streptococcus pneumoniae(30.4%),Staphylococcus epidermidis(13.0%), Acinetobacter(10.9%) and Enterobacter(8.8%). Second,Both quantitative sputum culture and quantitative sputum culture revealed the culture results: group one patients were mainly kind D(52.4% and69.2% respectively), group three patients were mainly resistant kind A(53.8% and52.9% respectively)and kind C(30.8% and29.4% respectively), P<0.01 and 0.05 respectively. Third,The resistance rate of S pneumoniae to penicillins, macrolide antibiotics, cephalosporins, lincomycins and quinolone was 100%, 72.2%, 55.6%, 50.0% and 38.9% respectively, and the sensitivity rate to vancomycin was 100%. The resistance rate of Moraxella Catarrhalis to penicillins and vancomycin was both 100%, macrolide antibiotics 80.0%, and the susceptibility rate to quinolone and carbapenems was both 100%. The resistance rate of Enterobacter to quinolone was 100%, cephalosporins and aminoglycoside antibiotics 60%, and the susceptibility rate to carbapenems was 100%. The resistance rate of Pseudomonas to quinolone and aminoglycoside...