Rao C Mohan, Sarbhai Kinshuk, Subhankar Saswat, Mohapatra Amrut, Singh Nipa, Panda Prem S, Patro Shubhransu, Pati Sanghamitra
Pulmonary Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Microbiology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2022 Jun 21;14(6):e26174. doi: 10.7759/cureus.26174. eCollection 2022 Jun.
Most of the acute exacerbations of chronic obstructive pulmonary disease (COPD) are due to infections, mostly due to bacteria and viruses. There is a need to study the outcome of microbe-induced airway inflammation.
It is an observational follow-up study from the pulmonary medicine department of Kalinga Institute of Medical Sciences with the participation of the Regional Medical ResearchCenter, Bhubaneswar, from October 2018 to February 2022. Patients who were admitted with acute exacerbation of COPD and treated as per GOLD (Global Initiative for Chronic Obstructive Lung Disease) 2021 guidelines were included in the study. Those patients in the severe category, who had clinically recovered, had undergone pulmonary physiotherapy, were on prescribed medications and home oxygen therapy after discharge, were followed up every three months by telephone calls. Any exacerbation, clinical stability, or mortality information was recorded.
Out of 197 cases, the majority were elderly, males, smokers, and belonged to urban areas; in total, 102 (51.8%) microbes were isolated as etiological agents of infective exacerbation in which 19.79% were viruses and 23.35% were bacteria, while coinfection was found in 8.62% cases. Among the viruses, rhinovirus, influenza virus, and respiratory syncytial virus were the major isolates. Among the bacteria, mostly gram-negative organisms such as , , and were isolated. Readmission was more among patients with coinfection.
Acute exacerbation of COPD was mostly seen in males in the age group of 61-80 years. Rhinovirus and influenza A virus were the two most common viral isolates, and among the bacterial isolates, and were predominantly detected. Poor clinical outcomes were noticed more among the coinfection group.
慢性阻塞性肺疾病（COPD）的大多数急性加重是由感染引起的，主要是细菌和病毒感染。有必要研究微生物诱导的气道炎症的结果。
这是一项来自卡林加医学科学研究所肺病科的观察性随访研究，于2018年10月至2022年2月期间，由布巴内斯瓦尔地区医学研究中心参与。纳入了因COPD急性加重入院并按照《慢性阻塞性肺疾病全球倡议》（GOLD）2021指南进行治疗的患者。那些病情严重但已临床康复、接受过肺部物理治疗、出院后正在服用规定药物并接受家庭氧疗的患者，每三个月通过电话进行随访。记录任何加重情况、临床稳定性或死亡率信息。
在197例病例中，大多数为老年人、男性、吸烟者，且来自城市地区；总共分离出102种（51.8%）微生物作为感染性加重的病原体，其中19.79%为病毒，23.35%为细菌，8.62%的病例存在合并感染。在病毒中，鼻病毒、流感病毒和呼吸道合胞病毒是主要分离株。在细菌中，主要分离出革兰氏阴性菌，如 、 和 。合并感染患者的再入院率更高。
COPD急性加重多见于61 - 80岁的男性。鼻病毒和甲型流感病毒是两种最常见的病毒分离株，在细菌分离株中，主要检测到 和 。合并感染组的临床结局较差。
