PDF(Pubmed)
Abstract：
OBJECTIVE: To assess differences in the sputum microbiota of community-acquired pneumonia (CAP) patients with either COPD or asthma, specifically focusing on a patient population in Turkey.
METHODS: This retrospective study included hospitalized patients > 18 years of age with a diagnosis of pneumonia between January of 2021 and January of 2023. Participants were recruited from two hospitals, and three patient groups were considered: CAP patients with asthma, CAP patients with COPD, and CAP patients without COPD or asthma.
RESULTS: A total of 246 patients with CAP were included in the study, 184 (74.8%) and 62 (25.2%) being males and females, with a mean age of 66 ± 14 years. Among the participants, 52.9% had COPD, 14.2% had asthma, and 32.9% had CAP but no COPD or asthma. Upon analysis of sputum cultures, positive sputum culture growth was observed in 52.9% of patients. The most commonly isolated microorganisms were Pseudomonas aeruginosa (n = 40), Acinetobacter baumannii (n = 20), Klebsiella pneumoniae (n = 16), and Moraxella catarrhalis (n = 8). CAP patients with COPD were more likely to have a positive sputum culture (p = 0.038), a history of antibiotic use within the past three months (p = 0.03), utilization of long-term home oxygen therapy (p < 0.001), and use of noninvasive ventilation (p = 0.001) when compared with the other patient groups. Additionally, CAP patients with COPD had a higher CURB-65 score when compared with CAP patients with asthma (p = 0.004).
CONCLUSIONS: This study demonstrates that CAP patients with COPD tend to have more severe presentations, while CAP patients with asthma show varied microbial profiles, underscoring the need for patient-specific management strategies in CAP.
METHODS: This retrospective study included hospitalized patients > 18 years of age with a diagnosis of pneumonia between January of 2021 and January of 2023. Participants were recruited from two hospitals, and three patient groups were considered: CAP patients with asthma, CAP patients with COPD, and CAP patients without COPD or asthma.
RESULTS: A total of 246 patients with CAP were included in the study, 184 (74.8%) and 62 (25.2%) being males and females, with a mean age of 66 ± 14 years. Among the participants, 52.9% had COPD, 14.2% had asthma, and 32.9% had CAP but no COPD or asthma. Upon analysis of sputum cultures, positive sputum culture growth was observed in 52.9% of patients. The most commonly isolated microorganisms were Pseudomonas aeruginosa (n = 40), Acinetobacter baumannii (n = 20), Klebsiella pneumoniae (n = 16), and Moraxella catarrhalis (n = 8). CAP patients with COPD were more likely to have a positive sputum culture (p = 0.038), a history of antibiotic use within the past three months (p = 0.03), utilization of long-term home oxygen therapy (p < 0.001), and use of noninvasive ventilation (p = 0.001) when compared with the other patient groups. Additionally, CAP patients with COPD had a higher CURB-65 score when compared with CAP patients with asthma (p = 0.004).
CONCLUSIONS: This study demonstrates that CAP patients with COPD tend to have more severe presentations, while CAP patients with asthma show varied microbial profiles, underscoring the need for patient-specific management strategies in CAP.
摘要：
目的：评估患有COPD或哮喘的社区获得性肺炎（CAP）患者的痰菌群差异，特别关注土耳其的患者群体。
方法：这项回顾性研究纳入了2021年1月至2023年1月诊断为肺炎的18岁以上住院患者。参与者来自两家医院，考虑了三个患者组：CAP哮喘患者，CAPCOPD患者，和无COPD或哮喘的CAP患者。
结果：共有246例CAP患者被纳入研究，184名（74.8%）和62名（25.2%）男性和女性，平均年龄66±14岁。在参与者中，52.9％患有COPD，14.2%有哮喘,32.9%有CAP但无COPD或哮喘。在分析痰培养后，52.9%的患者观察到痰培养阳性增长.最常见的分离的微生物是铜绿假单胞菌（n=40），鲍曼不动杆菌（n=20），肺炎克雷伯菌（n=16），和卡他莫拉菌（n=8）。COPDCAP患者痰培养阳性的可能性更大(p=0.038),过去三个月内抗生素使用史（p=0.03），长期家庭氧疗的使用（p<0.001），与其他患者组相比，使用无创通气（p=0.001）。此外,与患有哮喘的CAP患者相比，患有COPD的CAP患者的CURB-65评分更高（p=0.004）。
结论：这项研究表明，患有COPD的CAP患者往往有更严重的表现，虽然患有哮喘的CAP患者表现出不同的微生物特征，强调CAP中需要针对患者的管理策略。
方法：这项回顾性研究纳入了2021年1月至2023年1月诊断为肺炎的18岁以上住院患者。参与者来自两家医院，考虑了三个患者组：CAP哮喘患者，CAPCOPD患者，和无COPD或哮喘的CAP患者。
结果：共有246例CAP患者被纳入研究，184名（74.8%）和62名（25.2%）男性和女性，平均年龄66±14岁。在参与者中，52.9％患有COPD，14.2%有哮喘,32.9%有CAP但无COPD或哮喘。在分析痰培养后，52.9%的患者观察到痰培养阳性增长.最常见的分离的微生物是铜绿假单胞菌（n=40），鲍曼不动杆菌（n=20），肺炎克雷伯菌（n=16），和卡他莫拉菌（n=8）。COPDCAP患者痰培养阳性的可能性更大(p=0.038),过去三个月内抗生素使用史（p=0.03），长期家庭氧疗的使用（p<0.001），与其他患者组相比，使用无创通气（p=0.001）。此外,与患有哮喘的CAP患者相比，患有COPD的CAP患者的CURB-65评分更高（p=0.004）。
结论：这项研究表明，患有COPD的CAP患者往往有更严重的表现，虽然患有哮喘的CAP患者表现出不同的微生物特征，强调CAP中需要针对患者的管理策略。
