title: Lower respiratory tract infections in chronic obstructive pulmonary disease outpatients with tracheostomy and persistent colonization by P. aeruginosa.
abstract: 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 < 0.001). In conclusion, the rate of LRTI and hospital admissions in COPD outpatients with chronic tracheostomy was low, similar to non-COPD patients and independent of P. aeruginosa colonization.
authors.affiliation: Division of Pulmonary Disease, IRCCS (Institute for Care and Research), Scientific Institute of Rehabilitation, Salvatore Maugeri Foundation, Veruno (NO) I-28010, Italy. lusuardimi@ausl.re.it
authors.forename: M
authors.initials: M
authors.lastname: Lusuardi
authors.forename: A
authors.initials: A
authors.lastname: Capelli
authors.forename: A
authors.initials: A
authors.lastname: Di Stefano
authors.forename: S
authors.initials: S
authors.lastname: Zaccaria
authors.forename: B
authors.initials: B
authors.lastname: Balbi
authors.forename: C F
authors.initials: CF
authors.lastname: Donner
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011552:Pseudomonas Infections / Q000150:complications* / Q000188:drug therapy; D011550:Pseudomonas aeruginosa; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012131:Respiratory Insufficiency / Q000150:complications / Q000601:surgery*; D012141:Respiratory Tract Infections / Q000150:complications*; D012307:Risk Factors; D014139:Tracheostomy
chemical_list: D000900:Anti-Bacterial Agents