Sputum color as a marker of acute bacterial exacerbations of chronic obstructive pulmonary disease
Articolo
Data di Pubblicazione:
2005
Citazione:
Sputum color as a marker of acute bacterial
exacerbations of chronic obstructive
pulmonary disease / L. Allegra, F.B.A. Blasi, P.L. Diano, R. Cosentini, P. Tarsia, M. Confalonieri, K. Dimakou, V. Valenti. - In: RESPIRATORY MEDICINE. - ISSN 0954-6111. - 99:6(2005), pp. 742-747. [10.1016/j.rmed.2004.10.020]
Abstract:
We analyzed 795 sputa from 315 patients (233 males, mean age 69.378.8
years, mean number of exacerbations 2.52/patient) with acute exacerbations of
moderate-to-severe chronic obstructive pulmonary disease (COPD) (mean steady-state
FEV1 42.577.8% of predicted). 581/795 sputa were considered adequate. Sputum was
analyzed by a quali-quantitative colorimetric scale allowing both color distinction and
color degree of intensity. Quantitative culture was then performed (threshold:
4106 CFU/mL). Samples were distinguished in mucoid (145) and purulent (436) sputa.
Absence of bacterial growth was observed in 22% and 5% of mucoid and purulent sputa,
respectively. Among mucoid sputa, Gram positive bacterial growth occurred more
commonly compared to Gram negative and Pseudomonas aeruginosa/Enterobacteriaceae
(56%, 24%, 20%, respectively). In purulent sputa, Gram positives were found in
38% of cases, Gram negatives in 38%, and P. aeruginosa/Enterobacteriaceae in 24%. We
evaluated whether functional impairment (FEV1) orientates as to the infectious
etiology of exacerbations. Significant differences were observed in the distribution of
pathogens. Gram negative and P. aeruginosa/Enterobacteriaceae were isolated more
frequently in the sputum when FEV1 was o35%. Our study indicates that purulent
sputum is strongly associated with bacterial growth in COPD exacerbations. Deepening
sputum color (from yellowish to brownish) was associated with increased yield of Gram negative and P. aeruginosa/Enterobacteriaceae.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
COPD exacerbations; Lung function; Sputum purulence
Elenco autori:
L. Allegra, F.B.A. Blasi, P.L. Diano, R. Cosentini, P. Tarsia, M. Confalonieri, K. Dimakou, V. Valenti
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