Background and Aim: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has profound effects on disease
progression and patients’ quality of life. Emerging evidence suggests an association between alterations in the respiratory microbiome
flora species and airway inflammation in patients with AECOPD. The present study aimed to describe the inflammatory cells and
bacterial microbiome distributions in respiratory tract in Egyptian patients with AECOPD.
Subjects and Methods: The present cross-sectional study included 208 patients with AECOPD. Sputum and broncho-alveolar
lavage samples from the studied patients were submitted to microbial cultures using appropriate media. Total and differential
leukocytic counts and were done via automated cell counter.
Results: The present study included 208 AECOPD patients. They comprised 167 males (80.3%) and 41 females (19.7%) with an age
of 57.9 ± 4.9 years. AECOPD was categorized as mild, moderate and severe in 30.8%, 43.3% and 26%, respectively. Sputum samples
had significantly higher TLC, neutrophil percent and eosinophil percent when compared with BAL samples. In contrast,
lymphocyte percent was significantly higher in BAL samples. Sputum specimens had significantly lower frequency of positive
growths (70.2% versus 86.5%, p = 0.001). Among the identified organisms, sputum specimens had significantly lower frequency of
Strept. pneumoniae (14.4% versus 30.3%, p = 0.001), Klebsiella pneumoniae (19.7% versus 31.7%, p = 0.024), Haemophilus
influenzae (12.5% versus 26.9%, p = 0.011), Pseudomonas aeruginosa (2.9% versus 10%, p = 0.019) and Acinetobacter spp. (1.9%
versus 7.2%, p = 0.012) growths when compared with BAL samples.
Conclusion: The present study could identify a distinctive pattern of inflammatory cell distribution in sputum and BAL samples of
AECOPD patients. The most commonly isolated organisms were Klebsiella pneumoniae and Strept. pneumoniae. |
