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Bacterial infection in exacerbated COPD with changes in sputum characteristics

Published online by Cambridge University Press:  23 September 2003

E. MONSÓ
Affiliation:
Servei de Pneumologia, Hospital Germans Trias i Pujol, Badalona
J. GARCIA-AYMERICH
Affiliation:
Unitat de Recerca Respiratòria i Ambiental, Institut Municipal d'Investigació Médica, Barcelona, Spain
N. SOLER
Affiliation:
Servei de Pneumologia, Hospital Clínic i Provincial, Barcelona, Spain
E. FARRERO
Affiliation:
Servei de Pneumologia, Hospital de Bellvitge, L'Hospitalet del Llobregat, Spain
M. A. FELEZ
Affiliation:
Servei de Pneumologia, Hospital del Mar, Barcelona, Spain
J. M. ANTÓ
Affiliation:
Unitat de Recerca Respiratòria i Ambiental, Institut Municipal d'Investigació Médica, Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
A. TORRES
Affiliation:
Servei de Pneumologia, Hospital Clínic i Provincial, Barcelona, Spain
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Abstract

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We examined the risk factors for bacterial exacerbation, defined as the presence of pathogenic bacteria in sputum, in 90 chronic obstructive pulmonary disease (COPD) patients with an exacerbation and changes in sputum characteristics. Smoking, alcohol, lung function, body mass index, medical visits and treatments were the independent variables assessed using multivariable logistic regression modelling (OR, 95% CI). A bacterial exacerbation was diagnosed in 39 (43·3%) of 90 patients. Bacterial exacerbations were more prevalent among current smokers (OR 3·77, 95% CI 1·17–12·12), in patients with poor compliance with inhalation therapy (OR 3·25, 95% CI 1·18–8·93) and with severe lung function impairment (FEV1 OR 0·96, 95% CI 0·93-1·00). Prior use of antibiotics was a risk factor for Pseudomonas aeruginosa infection (OR 6·06, 95% CI 1·29–28·44) and influenza vaccination appeared to have a protective effect against this infection (OR 0·15, 95% CI 0·03–0·67). We conclude that severe impairment of lung function, smoking and poor compliance with therapy are risk factors for bacterial infection in COPD, and P. aeruginosa should be suspected in patients who have been treated with antibiotics and in those not vaccinated against influenza.

Type
Short Reports
Copyright
© 2003 Cambridge University Press