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The microbiological isolates in patients with non-CF bronchiectasis in stable clinical situation and in disease exacerbation

Abstract number: 1733_696

Kecelj P., Music E., Tomic V., Kosnik M., Erzen R.

Background: Isolation of potential pathogenic microorganisms (PPM) help in decision about first line antibiotic therapy in exacerbation of inflammation in bronhiectasis.

Methods and Patients: 68 patient (26 female, average age 68.2 years) with non CF bronchiectasis were included in two years retrospective study. Bronchectasis were diagnosed with CT scan. Patients were divided in group with (high CRP and WBC) and without exacerbation of the disease. Amount, quality and microbiological isolates of sputum were analysed in all patients. Antibiotic therapy of patients was recorded from medical documentation. Lung function was determinated by FEV1 and DLco.

Results: 35 patients (52%) were in group with no signs of inflammation. Average amount of sputum was 17 mL per day and purulence grade 1.0 of 3. Average FEV1 was 64% of normal values. Normal flora in sputum was found in 11% of patients. PPM were isolated in 48% of patients. Most frequent isolates were: P. aeruginosa in 11.4%, H. influenzae in 8.6%, Streptococcus spp. in 8.6%, MSSA in 8.6% of patients. Bacteria: A. baumannii, B. cepacia, A. xylosoxidans, M. catarrhalis, K. oxytoca were isolated in single patients. 33 patients (48%) were in group with exacerbation of disease. Average amount of sputum was 45 mL per day with purulence grade 2.5 of 3. Average FEV1 was 38% of normal. Normal flora in sputum was found in 24% of patients. Most frequent isolates were: P. aeruginosa in 30%, H. influenzae in 6%, Streptococcus spp. in 3%, MSSA in 15%, MRSA in 6% of patients. P. aeruginosa together with second bacteria was isolated in 10% of patients. In one patient H. influenzae and MSSA was isolated. Bacteria: A. baumannii, B. cepacia, A. xylosoxidans, M. catarrhalis, K. oxytoca, E. coli, E. cloacae were isolated in single patients.

Ciprofloxacin in combination with cephalosporins of 3th and 4th generation was therapy for all patients with isolated P. aeruginosa. In other patients AMC was used in 27%, ciprofloxacin in 20% of cases, others antibiotics were used seldom.

Conclusions: Potential pathogenic microorganisms were present in sputum in 48% of patients with clinically stable bronchiectasis, comparing to pathogenic microorganisms in 74% of patients with exacerbation of bronchiectasis. In exacerbation of the disease the empirical antibiotic therapy should be selected according to pervious antibiotic resistance pattern of PPM in patient, until the real pathogenic microorganisms are isolated.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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