Diferencias microbiológicas en pacientes con exacerbación severa de EPOC con o sin consolidación neumónica

Abstract

COPD is an important cause of morbidity and mortality around the world and it's prevalence in Bogotá rises up to 8,5%. Acute exacerbations affect functionality and life quality and therefore are considerated a cardinal factor in the disease. It has been described in the literature that bacteria and virus account for 78% of the exacerbations. However it is important to remark that these observations have been described in different populations, and there are no available data that show the local epidemiology of COPD exacerbations and also not from the ones associated with a pneumonic consolidation. Objective: To describe the microbiology from COPD severe exacerbations which require admission to the ICU with and without pneumonic consolidation. Materials and methods: We did a cross sectional study in which the population were patients diagnosed with COPD admitted to the ICU from FCI-IC because of a severe exacerbation associated or not with a pneumonic consolidation. We took microbiologic and serologic sample to study the etiology of the exacerbation and a thorax radiography to see if it was associated or not with pneumonia. Results: We did not found a difference that was statistically significative between the two evaluated groups. However we found a global bacterial resistance of 24% and an important prevalence of Serratia marcescens AMPc between the groups, which is not described as a common pathogen in the literature. We found differences in risk factors in the patients who had pneumonia such as a higher tobacco index (55.1.6 vs. 36.3 pack/ year, sig.=0.021). We also found that patients with associated pneumonia needed more ventilatory support with ventilation (48.9 vs. 23.9, sig.=0.013), and that there were no difference in mortality between the 2 groups (20.5 vs. 13.0, sig.=0.346). Conclusions: Even tough we did not found a significant difference in the microbiology from the two studied groups there are variables as risk factors and clinical variants of presentation that could help propose a therapy plan in the different scenarios of the disease. There should not be changes in the antibiotic therapy depending on associated pneumonia.