• 作者：X. Yang^a ; ^b ; M. Strobel^a ; L. Tian^c ; H. Barennes^a ; Y. Buisson^a ; ^{yves.buisson@auf.org}
• 关键词：COPD ; Sputum ; Quantitative bacteriology ; China
• 刊名：Médecine et Maladies Infectieuses
• 出版年：2011
• 出版时间：April 2011
• 年：2011
• 卷：41
• 期：4
• 页码：186-191
• 全文大小：166 K

Objective

Chinese recommendations for the management of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) include antibiotic treatments targeting the most frequently isolated pathogens according to the severity of COPD. The study objective was to check the relevance of these recommendations in Yunnan, a Southern Chinese province.

Patients and methods

A descriptive and analytical survey was conducted in the Kunming Medical University hospital among patients over 60 years of age, hospitalized with AECOPD, between March 2007 and June 2008.

Results

The 74 included patients were predominantly male (90 % ), with a mean age of 78.6 years, active or ex-smokers (81 % ), mainly with moderate (43 % ) or severe COPD (34 % ). Out of 87 AECOPD episodes, 47 (54 % ) yielded significant quantitative sputum cultures for S. pneumoniae (10 % ), P. aeruginosa (10 % ), H. influenzae (7 % ), M. catarrhalis (7 % ), and K. pneumoniae (7 % ). The positivity of sputum cultures was significantly linked with a history of smoking (P = 0.002). More than half of the P. aeruginosa isolates were multidrug resistant.

Conclusions

The distribution of pathogens isolated from EABPCO in Kunming corroborates published results. It does not question Chinese recommendations for first-line antibiotic therapy, but the high prevalence of P. aeruginosa and Enterobacteriaceae requires a periodic screening for acquired antibiotic resistance.