Division of Respiratory Medicine, Berne University Hospital, Freiburgstrasse, Berne, Switzerland.
Swiss Med Wkly. 2012 Jan 30;142:w13509. doi: 10.4414/smw.2012.13509. eCollection 2012.
P. aeruginosa infections are assumed to play a major role in the frequency of exacerbations and severity of chronic obstructive pulmonary disease (COPD). Colonisation with P. aeruginosa accelerates lung function decline, most probably due to more frequent exacerbations. In this retrospective study we aimed to determine the prevalence of colonisation with P. aeruginosa in COPD patients treated in a tertiary hospital centre.
112 patients diagnosed with COPD testing positive for P. aeruginosa in at least one respiratory sample during the study period (2004-2008) were retrospectively analysed to estimate GOLD stage-specific prevalences, colonisation patterns, morphology and antibiotic resistance profiles of P. aeruginosa strains.
Colonisation with P. aeruginosa was present in all COPD stages, but prevalence significantly increased with disease severity (GOLD 1: 0.7%, GOLD 2: 1.5%; GOLD 3: 1.5%; GOLD 4: 2.6%; p = 0.0003). 41% of COPD patients with P. aeruginosa-positive respiratory samples were chronic carriers, of whom 8% had mucoid strains. Carriage of a mucoid strain was associated with advanced COPD stage GOLD 4 (p = 0.01). Resistance to cephalosporins was most frequently encountered and resistance to ciprofloxacin was found in more advanced stages of COPD.
Colonisation with P. aeruginosa was present in all COPD severity stages and colonisation with mucoid strains was more frequent in advanced COPD. Resistance to the only oral anti-pseudomonas antibiotic ciprofloxacin was more frequently encountered in severe COPD stages.
铜绿假单胞菌感染被认为在慢性阻塞性肺疾病（COPD）的发作频率和严重程度中起主要作用。铜绿假单胞菌定植加速肺功能下降，很可能是由于更频繁的恶化。在这项回顾性研究中，我们旨在确定在一家三级医院中心治疗的 COPD 患者中铜绿假单胞菌定植的流行率。
在研究期间（2004-2008 年），至少有一个呼吸道样本中检测出铜绿假单胞菌阳性的 112 例确诊为 COPD 的患者进行了回顾性分析，以估计 GOLD 特定分期的流行率、铜绿假单胞菌定植模式、形态和抗生素耐药谱。
铜绿假单胞菌定植存在于所有 COPD 阶段，但随着疾病严重程度的增加，流行率显著增加（GOLD 1：0.7%；GOLD 2：1.5%；GOLD 3：1.5%；GOLD 4：2.6%；p=0.0003）。41%的铜绿假单胞菌阳性呼吸道样本 COPD 患者为慢性携带者，其中 8%为黏液型菌株。携带黏液型菌株与晚期 COPD 阶段 GOLD 4 相关（p=0.01）。最常遇到对头孢菌素的耐药性，并且在 COPD 的更晚期阶段发现对环丙沙星的耐药性。
铜绿假单胞菌定植存在于所有 COPD 严重程度阶段，黏液型菌株在晚期 COPD 中更为常见。在严重 COPD 阶段，对唯一的口服抗假单胞菌抗生素环丙沙星的耐药性更为常见。
