Clinical and laboratory aspects of diagnosis and treatment of chronic obstructive pulmonary disease infectious exacerbations in seniors of the Ministry of Defense of Ukraine
DOI:
https://doi.org/10.14739/2310-1210.2018.1.121997Keywords:
COPD, disease exacerbation, diagnosis, treatmentAbstract
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the world. The question of antibiotic therapy role during the COPD exacerbation remained for a long time not absolutely certain. It is likely that modern diagnostics, cupping and prevention of exacerbations come to the fore in patient with COPD care.
Objective – to examine the role of bacterial pathogens in COPD exacerbation development, to analyze diagnostic and therapeutic measures in Ministry of Defense of Ukraine (MDU) retired patients for the purpose of their optimization.
Materials and methods. A retrospective analysis was carried out of 72 stories of MDU retired men diseases, whose average age was (71.1 ± 1.20) years with an average length of disease (7.85 ± 0.51) years. The control group consisted of 20 practically healthy persons. To reveal the etiological structure of the COPD infectious exacerbation, the data of bacteriological sputum examination were used, which included the quantitative detection of the pathogen and its sensitivity to antibacterial drugs.
Results. A total of 30 strains of pathogens were obtained. The leading pathogen of COPD infectious exacerbation of MDU retired men turned out the Streptococcus family (53.3 %), such as S. pneumoniae, S. mitis, S. viridans, S. epedermidis and representatives of the Staphylococcus family (16.6 %). Two strains of Ps. Aeruginosa (6.6 %) were found among the entire patients contingent.
Conclusions. The leading causes of COPD exacerbations in pensioners of MDU mostly were hypothermia and acute viral respiratory infections – 49.9 %. Only acute viral respiratory infections were in 34.3 % of cases, only hypothermia – in 15.6 %. Physical overstrain and decompensation of concomitant pathology were less often. The most common the types I and II of exacerbations by Anthonisen were observed, which occurred in 44.5 % and 43.0 % of cases, respectively, the III type of exacerbations was found in 12.5 % of cases. The protected aminopenicillins and the III generation cephalosporins have remained high activity against the main pathogens of COPD exacerbation. In patients of the first group with microbiological sputum examination the number of days spent in the hospital (7.5 ± 0.36) was significantly less than in patients of the second group (11.3 ± 0.46) and the normalization of clinical and laboratory parameters after treatment was faster.
References
Feshchenko, Yu. I. (2011). Khronicheskoe obstruktivnoe zabolevanie legkih – aktual'naya mediko-social'naya problema [Chronic Obstructive Pulmonary Disease – a Topical Medical and Social Problem]. Ukrainskyi pulmonolohichnyi zhurnal, 2, 6. [in Ukrainian].
Halbert, R. J., Natoli, J. L., Gano, A., Badamgarav, E., Buist, A. S., & Mannino, D. M. (2006) Global burden of COPD: systematic review and metaanalysis. Eur Respir J. 2006, 28, 523–532. doi: 10.1183/09031936.06.00124605.
Talamo, C., de Oca, M. M., Halbert, R., Perez-Padilla, R., Jardim, J. R., Muino, A., et al. (2007) Diagnostic labeling of COPD in five Latin American cities. Chest, 131(1), 60 67. doi: 10.1378/chest.06-1149.
Tinkelman, D. G., Price, D. B., Nordyke, R. J., & Halbert, R. J. (2006) Misdiagnosis of COPD and asthma in primary care patients 40 years of age and over. J Asthma, 43(1), 75 80. doi: 10.1080/02770900500448738.
Soriano, J. B., Rigo, F., Guerrero, D., Yanez, A., Forteza, J. F., Frontera, G., et al. (2010) High prevalence of undiagnosed airflow limitation in patients with cardiovascular disease. Chest, 137(2), 333 340. doi: 10.1378/chest.09-1264.
Konoplova, L. F., & Rudenko, Yu. V. (2009) Khronichne leheneve sertse [Chronic Pulmonary Heart] Vnutrishnia medytsyna, (Vol. 2), (P. 158–178). Kyiv: Medytsyna [in Ukrainian].
Svintickij, A. S. (2012). Smertel'naya ugroza – khronicheskaya obstruktivnaya bolezn' legkikh [Mortal Threat – Chronic Obstructive Pulmonary Disease]. Uchastkovyi vrach, 7, 12–13. [in Russian].
Chuchalin, A. G. (2009). Bolezni organov dykhaniya i tabakokurenie [Respiratory diseases and tobacco smoking]. Terapevticheskij arkhiv, 81(3), 5–8. [in Russian].
Babanov, S. A. & Averina, O. M. (2012). KHOBL. Istoriya bolezni [COPD. Medical History]. Consilium medicum Ukraina, 14(3), 70–73. [in Ukrainian].
Dzyublik, Ya. D. (2014). Bronkhial'naya astma i HOZL v svete novykh rekomendacij [Bronchial asthma and COPD in the light of new recommendations]. Zdorov'e Ukrainy, 2, 4. [in Ukrainian].
Ostrovskyi, M. M. (2014). Sybri Bryzkhaler – novi mozhlyvosti ta shliakhy pokrashchennia kontroliu symptomiv ta zahostren KhOZL [Sybri Bryzhaler – new opportunities and ways to improve symptoms and exacerbations of COPD]. Ukrainskyi pulmonolohichnyi zhurnal, 2, 32–33. [in Ukrainian].
Yachnyk, A. I. (2011). Terapiia tiazhkoho zahostrennia KhOZL [Treatment of Severe Exacerbation of COPD]. Zdorovia Ukrainy, 4, 32. [in Ukrainian].
Mostovoj, Yu. M. (2011). Vybor antibakterial'nogo preparata pri obostrenii KHOZL v ambulatornykh usloviyakh na osnovanii farmakoe'konomicheskogo analiza [Choice of Antibiotics for Exacerbation of COPD in Outpatient Conditions on the Basis of Pharmacoeconomic Analysis]. Ukrainskyi pulmonolohichnyi zhurnal, 3, 18–19. [in Ukrainian].
Anthonisen, N. R., Manfreda, J., Warren, C. P., Hershfield, E. S., Harding, G. K., & Nelson, N. A. (1987) Antibiotic therapy in exacerbations of COPD. Ann Intern Med, 106, 196–204.
Yudina, L. V. (2011). Infekcionnoe obostrenie KHOZL: Kakoj antibiotik predpochest'? [Infectious Exacerbation of COPD: Which Antibiotic is Preferred?]. Ukrainskyi pulmonolohichnyi zhurnal, 1, 66–68. [in Ukrainian].
Pertseva, Т. О., Konopkina, L. I., & Plechanova, O. V. (2006). Osnovy ta dosvid antybakterialnoi terapii infektsiinykh zahostren khronichnoho obstruktyvnoho zakhvoriuvannia lehen na ambulatorno-poliklinichnomu etapi [Rationale and experience of out
Chuchalin, A. G. (2010). Khronicheskaya obstruktivnaya bolezn' legkikh [Chronic Obstructive Pulmonary Disease]. Zdorov'ya Ukrainy, 3, 40–41. [in Ukrainian].
Lopez, A. D., Shibuya, K., Rao, C., Mathers, C. D., Hansell, A. L., Held, L. S., et al. (2006). Chronic obstructive pulmonari disease: current burden and fufure prijections. Eur. Respir. J., 27, 397–412. doi: 10.1183/09031936.06.00025805.
Demko, I. V., Sobko, E. A., Solov'eva, I. A., Ishchenko, O. P., Kraposhina, A. Yu., Gordeeva, N. V., et al. (2016). Osobennosti antimikrobnoj terapii u bol'nykh khronicheskoj obstruktivnoj bolezn'yu lyogkikh [Special consideration of antibacterial therapy in patients with chronic obstructive pulmonary disease]. Pul'monologiya, 25(5), 618–622. [in Russian].
Eldere, J. V. (2010). Antibiotikorezistentnost' osnovnykh vozbuditelej infekcionnykh obostrenij KHOZL [Antibiotic resistance of the main pathogens of infectious exacerbations of COPD]. Zdorov'ya Ukrainy, 9. [in Russian].
Pavord, I. D., Jones, P. W., Burgel, P. R., & Rabe, K. F. (2016) Exacerbations of COPD. Int. J. Chron. Obstruct. Pulm.Dis., 11, 21–30.
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)