Lower respiratory tract infections in chronic obstructive pulmonary disease outpatients with tracheostomy and persistent colonization by P. aeruginosa

• Published in: Respiratory medicine 2003-11, Vol.97 (11), p.1205-1210
• Main Authors: Lusuardi, M, Capelli, A, Di Stefano, A, Zaccaria, S, Balbi, B, Donner, C.F
• Format: Article
• Language: English
• Subjects: Aged; Ambulatory Care; Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacterial colonization; Biological and medical sciences; Chronic Disease; Chronic obstructive pulmonary disease, asthma; COPD; Female; Follow-Up Studies; Hospitalization - statistics & numerical data; Humans; LRTI; Male; Medical sciences; Middle Aged; Pneumology; Postoperative Care; Pseudomonas aeruginosa; Pseudomonas Infections - complications; Pseudomonas Infections - drug therapy; Pulmonary Disease, Chronic Obstructive - complications; Respiratory Insufficiency - complications; Respiratory Insufficiency - surgery; Respiratory Tract Infections - complications; Risk Factors; Tracheostomy
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/S0954-6111(03)00231-2

Outpatients with tracheostomy can be managed with a low risk for severe airways infections despite colonization with pathogenic bacteria. No studies have been focused on chronic obstructive pulmonary disease (COPD), a condition known for recurrent exacerbations. The aim of our study was to verify whether at follow-up in tracheostomized COPD versus other disease outpatients, persistent P. aeruginosa colonization may influence the rate and treatment of lower respiratory tract infections (LRTI) or hospital admissions. Thirty-nine outpatients were considered: 24 were affected by COPD (age 66, 54–78 years, mean, range), 15 by restrictive lung disease (RLD) (57, 41–72 years). During an 18-month follow-up the number of LRTIs were recorded. Bacterial identifications were assessed at baseline and every month for 6 months in bronchial aspirates. The number of LRTI per patient was not significantly different between COPD [37, 1(0–6)] and RLD [18, 1(0–5)], [total, median (range)]. Persistent P. aeruginosa colonized 18 COPD (75%), 12 RLD patients (86%) and was not associated with an increased number of LRTI: 1(0–6) and 1(0–2), respectively. There were no differences in the number of hospital admissions: COPD 0(0–2), RLD 1(0–1), with a significant decrease versus before tracheostomy ( P