Microbiological airway colonization in COPD patients with severe emphysema undergoing endoscopic lung volume reduction

Figures & data

Table 1 Microbiological characterization of bacterial and fungal lower airway colonization of 64 COPD patients undergoing endoscopic lung volume reduction for advanced emphysema in Homburg, Germany, between March 2012 and March 2017

Pathogen	Total (n=64)
	n	%
Total number of positive samples	30a	47
Bacteria	23a	36
Gram-positive bacteria	10	16
Staphylococcus aureus	4	6
Streptococcus constellatus	1	2
Streptococcus pneumoniae	4	6
Streptococcus pyogenes	1	2
Gram-negative bacteria	17a	27
Achromobacter xylosoxidans	1	2
Bordetella bronchiseptica	1	2
Enterobacter cloacae complex	1	2
Haemophilus influenzae	6	9
Haemophilus parainfluenzae	2	3
Klebsiella pneumoniae	2	3
Moraxella catarrhalis	1	2
Pseudomonas aeruginosa	3	5
Serratia marcescens	2	3
Stenotrophomonas maltophilia	1	2
Fungi	8a	13
Yeasts	6	9
Candida albicans	5	6
Candida glabrate	3	5
Candida krusei	1	2
Molds	2	3
Aspergillus terreus	1	2
Penicillium spp.	1	2

Note:

a Cocolonization with different organisms was found in some patients.

Table 2 Comparison of baseline characteristics in patients undergoing endoscopic lung volume reduction in Homburg, Germany (2012–2017), stratified by microbiological airway colonization

Clinical presentation	All patients, N=64	Not colonized, N=34	Colonized, N=30	P-value
Age (years)	62.41±8.67	62.28±8.25	62.56±9.26	0.901
Male (N)	32/64 (50)	14/34 (41)	18/30 (60)	0.210
Height (m)	1.66±0.10	1.65±0.11	1.67±0.10	0.680
Weight (kg)	62.29±14.88	59.91±13.70	64.99±15.91	0.180
BMI (kg/m^2)	22.52±4.50	21.81±4.29	23.32±4.66	0.184
6MWT (m)a	259.37±109.69	248.58±99.44	271.66±120.91	0.419
Blood gas analysis
PaO2 <55 mmHg and/or LTO	48/64 (75)	26/34 (76)	22/30 (73)	0.781
PaCO2 >50 mmHg	18/64 (28)	15/34 (44)	3/30 (10)	0.002*
Baseline lung function
FEV1 (L)	0.70±0.30	0.62±0.18	0.80±0.37	0.022*
FEV1 (%)	27.25±9.50	24.81±7.02	30.01±11.35	0.035*
VC (L)	2.11±0.87	1.95±0.79	2.29±0.93	0.132
VC (%)	62.72±20.11	59.81±20.37	66.03±19.62	0.219
RV (L)	5.86±1.33	6.09±1.41	5.59±1.20	0.136
RV (%)	271.71±72.04	284.70±59.78	256.98±82.37	0.134
TLC (L)	7.91±1.61	7.99±1.76	7.83±1.46	0.703
TLC (%)	140.09±21.30	143.69±18.87	136.02±23.42	0.158
RV/TLC	73.47±8.23	75.97±7.78	70.64±7.92	0.009*

Notes: Values are presented as n (%) or mean ± SD.

* P≤0.05 was considered statistically significant.

a 6MWT results were only available for 62 patients.

Abbreviations: BMI, body mass index; FEV₁, forced expiratory volume in 1 second; LTOT, long-term oxygen therapy; 6MWT, 6-minute walking test; PaCO₂, partial pressure of carbon dioxide; PaO₂, partial pressure of oxygen; RV, residual volume; TLC, total lung capacity; VC, vital capacity.

Table 3 Antibiotic nonsusceptibility patterns of the most frequently detected Gram-positive and Gram-negative bacterial species in bronchial aspirates from 64 COPD patients undergoing endoscopic lung volume reduction in Homburg, Germany, between March 2012 and March 2017

	N	Nonsusceptibility of isolates against the antibiotics listed below
		Ampicillin/sulbactam	Piperacillin/tazobactam	Cefotaxime	Ceftazidime	Meropenem	Ciprofloxacin	Gentamicin	Erythromycin
Gram-positive bacteria
Staphylococcus aureus	4	0	0	0	–	0	1	0	3
Streptococcus pneumoniae	4	0	0	0	–	0	–	–	NT
Gram-negative bacteria
Haemophilus spp.	8	2	–	0	–	0	NT	–	8
Klebsiella pneumoniae	2	0	0	0	0	0	0	0	–
Pseudomonas aeruginosa	3	–	1	–	0	0	1	1	–
Serratia marcescens	2	2	0	0	0	0	0	0	–

Notes: Nonsusceptibility was defined as either “intermediate” or “resistant” results upon antimicrobial susceptibility testing. Clinical breakpoints issued by EUCAST were employed. –, lack of species-specific breakpoints for this antibiotic, eg, due to insufficient clinical evidence supporting the use of the antibiotic for the given pathogen. NT, not tested in this study (despite available clinical breakpoint).

Abbreviation: EUCAST, European Committee on Antimicrobial Susceptibility Testing.