ĐÁNH GIÁ KẾT QUẢ VI KHUẨN VÀ MỐI LIÊN QUAN VỚI ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG TRONG ĐỢT CẤP CỦA BỆNH PHỔI TẮC NGHẼN MẠN TÍNH

Abstract

Objective: Bacteriological characteristics determined by sputum culture, real-time PCR techniques to quantify atypical bacteria and their relationship to clinical and paraclinical in exacerbation of COPD. Subject and method: This is a cross-sectional study, evaluate bacterial results in sputum conducted on 180 patients who was diagnosed with acute exacerbation of COPD and had inpatient treatment at National Lung Hospital, Vietnam from September 2016 to May 2021. Results: 67 cases of bacteria were positive (37.2%), negative (62.8%). Prevalence of bacterial species among positive patients: P. aeruginosa (20,9%), H. influenzae (17,9%), S. pneumoniae (11,9%), A. baumannii (10,4%), M. catarrhalis (9,0%), K. pneumoniae (6,0%), Stenotrophomanas maltophilia (3,0%), S. areus (3,0%). Atypical bacteria group: L. pneumophila (11.9%), M, pneumoniae (4.5%), Chlamydia pneumoniae (1.5%). Multivariable logistic regression analysis showed the number of exacerbations per year (>3 exacerbations), pulmonary rales, WB > 10G/L, CRP ≥ 40 mg/l, abnormal HCO₃^_, dirty lung images and bronchial wall thickening on chest Xray are symptoms that predict bacterial infection in COPD exacerbations (p<0.05). Conclusion: The results of bacteria identified in sputum using culture methods and realtime PCR techniques to detect DNA of some atypical bacteria are meaningful for clinical practice in choosing the use of antibiotics. reasonable in the treatment of COPD exacerbations.