Etiology Analysis and Antimicrobial Selection in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective: This study was conducted to prospectively analyze the clinical features of hospitalized patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD), sputum culture and drug susceptibility results, and the use and efficacy of antimicrobial to guide the pathogens of AECOPD hospitalized patients. Learning judgment and choice of antimicrobial drugs. Materials and Methods: A total of 327 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine, Jingzhou Central Hospital from January 1, 2018 to December 31, 2018 were enrolled. Among them, 46 patients were positive for sputum microbial culture, and 48 positive sputum culture results were obtained. The demographic characteristics (age, gender, BMI index), smoking history, acute exacerbation/year, mMRC score were statistically analyzed. CAT score, lung function index, presence or absence of respiratory failure, sputum culture type and drug sensitivity, antibacterial drug selection. All data were tabulated and divided into 2 groups according to the presence or absence of respiratory failure. The clinical data and etiology differences of the 2 groups were counted. According to the sputum culture, G-negative two clinical data of the two were The measurement data mean±standard error, and the percentage was used. The statistical analysis was performed by Fisher’s exact test. The measurement data were analyzed by independent sample t test. The count data were analyzed by chi-square test. The P value was less than 0.05, which was statistically significant. and fungi between the first sputum culture and the non-first sputum culture (P=0.018), suggesting that the late stage of hospi talization was fungal infection. FEV1 and FVC between the respiratory failure group (14 cases) and the non-respiratory failure group (34 cases). AE/year was statistically significant (P<0.05), 2 groups. Candida albicans is the main pathogen in the patients. According to the pathogen, G-negative bacilli and fungi were divided into two groups. There was no significant difference in age, BMI, mMRC, CAT, AE times/year, FEV1 and FVC between the two groups. Conclusion: G-negative bacilli and fungal infections were the most common in male, elderly, and recurrent AECOPD hospitalized patients, with the highest incidence of Candida albicans infection. Fungi was main source of infection in the late stay after 5 to 7 days of hospitalization. Candida albicans is most common positive pathogen in hospitalized patients regardless of whether it is associated with respiratory failure. This suggests that our combination of antibacterial and antifungal drugs in clinical treatment, especially in the late hospital stay can benefit these patients. involved of bacteria, fungi and viruses. In our prospective study we analyzed the micro-organism profile of the patients with COPD at acute exac erbation and their antimicrobial sensitivity. G-negative bacilli and fungal infections were the most common in male, elderly, recurrent and severely symptomatic AECOPD hospitalized patients, with the highest incidence of Candida Albicans infection. Fungi was the main source of infection in the late stay (after 5 to 7 days) of hospitalization. Candida Albicans is the most common positive pathogen in hospitalized patients with AECOPD regardless of whether it is associated with respiratory failure. This suggests that our combination of antibacterial and antifungal drugs in clinical treatment can benefit these patients, especially in their late hospital stay. However, due to the small sample size of the positive sputum, the conclusion may be selective bias. A Large sample and/or multi-center data statistics are necessary to get closer to the clinical reality. Environmental factors including air pollution influence the rate of AECOPD.